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General NPI Number Information
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NPI Number | 1073755575
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Entity Type | Organization
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Legal Business Name | TENNESSEE VALLEY CLINIC OF CHIROPRACTIC PC
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Dates
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Enumeration Date | 03/30/2009
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Last Update Date | 03/30/2009
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Provider Practice Location Address
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Address Line | 304 1ST AVE
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City | DAYTON
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State | TN
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Zip | 37321-1290
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Country | US
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Telephone | 423-775-6688
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Fax | 423-775-8777
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Provider Business Mailing Address
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Address Line | PO BOX 996
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City | DAYTON
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State | TN
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Zip | 37321-0996
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Country | US
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Telephone | 423-775-6688
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Fax | 423-775-8777
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KEVIN JOEL MOORE
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Credential | D.C.
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Telephone | 423-775-6688
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | DC0000002218
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License Number State | TN
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