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General NPI Number Information
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NPI Number | 1023460631
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Entity Type | Individual
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Provider Name | WILLIAM FREDERICK MARTIN III D.C.
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Gender | Male
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Dates
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Enumeration Date | 07/07/2016
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Last Update Date | 01/03/2024
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Provider Practice Location Address
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Address Line | 2330 MERCHANT DR STE C
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City | KNOXVILLE
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State | TN
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Zip | 37912-5136
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Country | US
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Telephone | 360-723-7839
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Fax |
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Provider Business Mailing Address
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Address Line | 119 EARLY DR
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City | POWELL
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State | TN
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Zip | 37849-7102
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Country | US
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Telephone | 360-723-7839
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 0000003500
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License Number State | TN
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