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General NPI Number Information
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NPI Number | 1295928307
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Entity Type | Organization
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Legal Business Name | ABSOLUTE HEALING CHIROPRACTIC
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Dates
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Enumeration Date | 08/22/2007
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Last Update Date | 08/22/2007
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Provider Practice Location Address
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Address Line | 211 SHERWAY RD FRNT B
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City | KNOXVILLE
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State | TN
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Zip | 37922-2241
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Country | US
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Telephone | 865-670-0650
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Fax | 865-531-0480
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Provider Business Mailing Address
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Address Line | 211 SHERWAY RD FRNT B
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City | KNOXVILLE
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State | TN
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Zip | 37922-2241
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Country | US
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Telephone | 865-670-0650
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Fax | 865-531-0480
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Authorized Official
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Title or Position | OWNER/ DOCTOR
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Name | DR. EDWARD ALEXANDER BLANCO
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Credential | DC
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Telephone | 865-670-0650
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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 | DC1562
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License Number State | TN
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