Healthcare Provider Details

I. General information

NPI: 1285266031
Provider Name (Legal Business Name): GEMINI WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2020
Last Update Date: 02/10/2020
Certification Date: 02/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2933 BERRY HILL DR BLDG B
NASHVILLE TN
37204-3126
US

IV. Provider business mailing address

2933 BERRY HILL DR BLDG B
NASHVILLE TN
37204-3126
US

V. Phone/Fax

Practice location:
  • Phone: 615-500-4679
  • Fax:
Mailing address:
  • Phone: 615-500-4679
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: SUMAN CHAUDHURI
Title or Position: OWNER
Credential: DC
Phone: 615-500-4679