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General NPI Number Information
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NPI Number | 1295107613
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Entity Type | Organization
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Legal Business Name | CHIRO2MED OF TENNESSEE
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Dates
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Enumeration Date | 10/25/2015
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Last Update Date | 08/25/2016
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Provider Practice Location Address
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Address Line | 750 E SPRING ST SUITE D
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City | COOKEVILLE
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State | TN
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Zip | 38501-4527
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Country | US
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Telephone | 931-526-4084
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Fax | 931-526-6801
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Provider Business Mailing Address
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Address Line | 750 E SPRING ST SUITE D
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City | COOKEVILLE
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State | TN
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Zip | 38501-4527
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Country | US
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Telephone | 931-526-4084
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Fax | 931-526-6801
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Authorized Official
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Title or Position | OWNER
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Name | MITCHELL SHEA
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Credential |
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Telephone | 931-526-4084
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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