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General NPI Number Information
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NPI Number | 1205339033
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Entity Type | Organization
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Legal Business Name | IGNITE CHIROPRACTIC, LLC
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Dates
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Enumeration Date | 03/18/2018
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Last Update Date | 03/18/2018
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Provider Practice Location Address
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Address Line | 200 MANUFACTURERS RD STE 210
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City | CHATTANOOGA
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State | TN
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Zip | 37405
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Country | US
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Telephone | 203-994-2072
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Fax |
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Provider Business Mailing Address
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Address Line | 200 MANUFACTURERS RD STE 210
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City | CHATTANOOGA
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State | TN
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Zip | 37405
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Country | US
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Telephone | 203-994-2072
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JEFFREY LAFLAMME
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Credential | DC
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Telephone | 203-994-2072
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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 | 3094
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License Number State | TN
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