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General NPI Number Information
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NPI Number | 1245719012
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Entity Type | Organization
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Legal Business Name | DALE B FARRIS JR
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Dates
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Enumeration Date | 08/12/2018
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Last Update Date | 02/06/2025
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Provider Practice Location Address
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Address Line | 1210 W MAIN ST
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City | DECHERD
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State | TN
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Zip | 37324-3607
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Country | US
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Telephone | 931-313-5276
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Fax | 931-313-5375
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Provider Business Mailing Address
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Address Line | 1210 W MAIN ST
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City | DECHERD
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State | TN
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Zip | 37324-3607
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Country | US
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Telephone | 931-313-5276
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Fax | 931-313-5375
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Authorized Official
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Title or Position | OWNER OF PRACTICE
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Name | DALE FARRIS
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Credential | DC
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Telephone | 615-330-8867
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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 | 2929
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License Number State | TN
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