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General NPI Number Information
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NPI Number | 1083615553
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Entity Type | Individual
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Provider Name | WOODROW W GWINN JR. D.C.
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Gender | Male
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Dates
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Enumeration Date | 08/09/2005
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Last Update Date | 05/21/2020
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Provider Practice Location Address
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Address Line | 1812 E LAMAR ALEXANDER PKWY
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City | MARYVILLE
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State | TN
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Zip | 37804-5283
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Country | US
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Telephone | 865-977-0916
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Fax | 865-984-3519
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Provider Business Mailing Address
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Address Line | 1812 E LAMAR ALEXANDER PKWY
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City | MARYVILLE
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State | TN
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Zip | 37804-5283
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Country | US
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Telephone | 865-977-0916
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Fax | 865-984-3519
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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 | 845
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC336
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License Number State | TN
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