Healthcare Provider Details
I. General information
NPI: 1538109533
Provider Name (Legal Business Name): CHARLES HOWARD MEANS DC
Entity Type: Individual
Gender: Male
Sole Proprietor: X
II. Dates (important events)
Enumeration Date: 06/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2905 TAZEWELL PIKE
KNOXVILLE TN
37918-1874
US
IV. Provider business mailing address
2905 TAZEWELL PIKE
KNOXVILLE TN
37918-1874
US
V. Phone/Fax
- Phone: 865-686-1600
- Fax: 868-686-3380
- Phone: 865-686-1600
- Fax: 865-686-3380
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | DC0000001187 |
| License Number State | TN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: