Healthcare Provider Details

I. General information

NPI: 1740081884
Provider Name (Legal Business Name): ZACHERY MAIN DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2025
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7315 CLINTON HWY STE C
POWELL TN
37849-5225
US

IV. Provider business mailing address

2451 SUNRISE RIDGE WAY APT 211
KNOXVILLE TN
37921-1288
US

V. Phone/Fax

Practice location:
  • Phone: 865-205-1185
  • Fax:
Mailing address:
  • Phone: 872-777-6880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4108
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number4108
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: