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General NPI Number Information
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NPI Number | 1124495783
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Entity Type | Organization
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Legal Business Name | FULL CIRCLE CHIROPRACTIC
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Dates
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Enumeration Date | 08/29/2015
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Last Update Date | 01/25/2024
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Provider Practice Location Address
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Address Line | 184 OLD MOUSE CREEK RD NW
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City | CLEVELAND
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State | TN
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Zip | 37312-3835
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Country | US
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Telephone | 423-478-8989
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Fax |
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Provider Business Mailing Address
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Address Line | 55 MOUSE CREEK RD NW
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City | CLEVELAND
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State | TN
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Zip | 37312-4840
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Country | US
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Telephone | 423-478-8989
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Fax |
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Authorized Official
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Title or Position | CLINIC DIRECTOR
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Name | PAULA EMMA WARREN
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Credential | DC
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Telephone | 563-581-3103
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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 | 076557
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License Number State | IA
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