Healthcare Provider Details

I. General information

NPI: 1013973361
Provider Name (Legal Business Name): BOB G HARTMAN DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

816 TUSCULUM BLVD
GREENVILLE TN
37745-4002
US

IV. Provider business mailing address

816 TUSCULUM BLVD
GREENVILLE TN
37745-4002
US

V. Phone/Fax

Practice location:
  • Phone: 423-639-1431
  • Fax: 423-639-0827
Mailing address:
  • Phone: 423-639-1431
  • Fax: 423-639-0827

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC82
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: