Healthcare Provider Details

I. General information

NPI: 1477957660
Provider Name (Legal Business Name): COMMUNITY CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2014
Last Update Date: 10/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8110 HWY 51 NORTH SUITE 2
MILLINGTON TN
38053
US

IV. Provider business mailing address

8110 HWY 51 NORTH SUITE 2
MILLINGTON TN
38053
US

V. Phone/Fax

Practice location:
  • Phone: 901-872-0760
  • Fax: 901-872-3120
Mailing address:
  • Phone: 901-872-0760
  • Fax: 901-872-3120

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberTN14411DC
License Number StateTN

VIII. Authorized Official

Name: DR. CURTIS E DAMIEN
Title or Position: OWNER/ DOCTOR
Credential: DC
Phone: 901-872-0760