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General NPI Number Information
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NPI Number | 1043192842
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Entity Type | Individual
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Provider Name | ERIC ETHRIDGE DC
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Gender | Male
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Dates
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Enumeration Date | 07/23/2025
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Last Update Date | 07/23/2025
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Provider Practice Location Address
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Address Line | 313 BLUEBIRD DR # B
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City | GOODLETTSVILLE
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State | TN
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Zip | 37072-2303
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Country | US
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Telephone | 615-448-6446
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Fax |
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Provider Business Mailing Address
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Address Line | 635 FOSTER LN
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City | MOUNT JULIET
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State | TN
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Zip | 37122-3944
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Country | US
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Telephone | 615-864-2048
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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 | 3924
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License Number State | TN
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