Healthcare Provider Details

I. General information

NPI: 1568876886
Provider Name (Legal Business Name): NASHVILLE SPINE AND SPORT CHIROPRACTIC CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2014
Last Update Date: 06/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2021 RICHARD JONES RD #100
NASHVILLE TN
37215
US

IV. Provider business mailing address

2021 RICHARD JONES RD #100
NASHVILLE TN
37215
US

V. Phone/Fax

Practice location:
  • Phone: 615-920-5869
  • Fax:
Mailing address:
  • Phone: 615-920-5869
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number2548
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2548
License Number StateTN

VIII. Authorized Official

Name: DR. SCOTT A. FOOTE
Title or Position: CHIROPRACTOR
Credential: D.C.
Phone: 615-920-5869