Healthcare Provider Details

I. General information

NPI: 1952059321
Provider Name (Legal Business Name): EADC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2022
Last Update Date: 03/15/2022
Certification Date: 03/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12908 LEBANON RD
MT JULIET TN
37122-2865
US

IV. Provider business mailing address

12908 LEBANON RD
MT JULIET TN
37122-2865
US

V. Phone/Fax

Practice location:
  • Phone: 615-288-2671
  • Fax:
Mailing address:
  • Phone: 615-288-2671
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. ERIN DARTE
Title or Position: OWNER
Credential: DC
Phone: 618-444-6008