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General NPI Number Information
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NPI Number | 1043497498
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Entity Type | Organization
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Legal Business Name | GREENEVILLE CHIROPRACTIC INC
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Dates
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Enumeration Date | 01/29/2008
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Last Update Date | 01/30/2008
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Provider Practice Location Address
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Address Line | 155 MASON ST
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City | GREENEVILLE
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State | TN
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Zip | 37745-4014
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Country | US
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Telephone | 423-638-5361
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Fax |
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Provider Business Mailing Address
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Address Line | 155 MASON ST
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City | GREENEVILLE
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State | TN
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Zip | 37745-4014
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Country | US
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Telephone | 423-638-5361
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MR. LEONARD HARTMAN
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Credential | DC
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Telephone | 423-638-5361
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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 | DC0000000104
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License Number State | TN
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