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General NPI Number Information
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NPI Number | 1164784823
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Entity Type | Organization
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Legal Business Name | STEWART CHIROPRACTIC CENTER PC
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Dates
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Enumeration Date | 06/08/2012
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Last Update Date | 06/18/2012
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Provider Practice Location Address
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Address Line | 104 GLEN OAK BLVD STE 140
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City | HENDERSONVILLE
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State | TN
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Zip | 37075-6423
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Country | US
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Telephone | 615-924-2668
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Fax |
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Provider Business Mailing Address
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Address Line | 1070 W MAIN ST 1403
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City | HENDERSONVILLE
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State | TN
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Zip | 37075-2858
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Country | US
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Telephone | 615-924-2668
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Fax |
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Authorized Official
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Title or Position | DOCTOR OF CHIROPRACTIC
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Name | DR. SAMUEL THOMAS STEWART
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Credential | D.C.
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Telephone | 615-924-2668
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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 | 2588
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License Number State | TN
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