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General NPI Number Information
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NPI Number | 1255602819
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Entity Type | Individual
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Provider Name | TRENT MICHAEL HIPPARD D.C.
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Gender | Male
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Dates
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Enumeration Date | 01/13/2012
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Last Update Date | 12/28/2021
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Provider Practice Location Address
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Address Line | 120 CAPITAL DR STE 103
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City | KNOXVILLE
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State | TN
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Zip | 37922-3475
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Country | US
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Telephone | 865-474-1479
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Fax |
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Provider Business Mailing Address
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Address Line | 120 CAPITAL DR STE 103
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City | KNOXVILLE
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State | TN
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Zip | 37922-3475
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Country | US
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Telephone | 815-298-3667
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 038.011992
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 0000003312
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License Number State | TN
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