Healthcare Provider Details

I. General information

NPI: 1083612105
Provider Name (Legal Business Name): JOSEPH M GEBHARDT D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 07/12/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4825 TROUSDALE DR 214
NASHVILLE TN
37220-1335
US

IV. Provider business mailing address

4825 TROUSDALE DR 214
NASHVILLE TN
37220-1335
US

V. Phone/Fax

Practice location:
  • Phone: 615-331-5938
  • Fax:
Mailing address:
  • Phone: 615-331-5938
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1863
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: