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General NPI Number Information
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NPI Number | 1124529268
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Entity Type | Organization
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Legal Business Name | LAUNCH CHIROPRACTIC LLC
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Dates
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Enumeration Date | 02/23/2018
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Last Update Date | 02/23/2018
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Provider Practice Location Address
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Address Line | 9076 POPLAR PIKE STE 102
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City | GERMANTOWN
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State | TN
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Zip | 38138-8232
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Country | US
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Telephone | 901-308-4747
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Fax |
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Provider Business Mailing Address
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Address Line | 9076 POPLAR PIKE STE 102
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City | GERMANTOWN
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State | TN
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Zip | 38138-8232
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Country | US
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Telephone | 901-308-4747
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ANTHONY STASI
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Credential | DC
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Telephone | 901-308-4747
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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 | 3093
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License Number State | TN
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