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General NPI Number Information
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NPI Number | 1144580408
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Entity Type | Organization
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Legal Business Name | GUARDIAN CHIROPRACTIC PLLC
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Dates
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Enumeration Date | 05/21/2012
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Last Update Date | 05/21/2012
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Provider Practice Location Address
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Address Line | 129 INDIAN LAKE RD
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City | HENDERSONVILLE
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State | TN
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Zip | 37075-3820
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Country | US
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Telephone | 615-822-7421
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Fax | 615-822-7475
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Provider Business Mailing Address
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Address Line | 129 INDIAN LAKE ROAD
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City | HENDERSONVILLE
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State | TN
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Zip | 37075
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Country | US
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Telephone | 615-822-7421
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Fax | 615-822-7475
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KENNETH RAY STOHR JR.
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Credential | D.C
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Telephone | 615-822-7421
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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 | 2603
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License Number State | TN
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