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General NPI Number Information
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NPI Number | 1316985922
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Entity Type | Organization
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Legal Business Name | NORTHSHORE CHIROPRACTIC CLINIC LLC
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Dates
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Enumeration Date | 06/04/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 9305 S NORTHSHORE DR
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City | KNOXVILLE
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State | TN
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Zip | 37922-6548
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Country | US
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Telephone | 865-670-7577
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Fax | 865-670-6686
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Provider Business Mailing Address
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Address Line | 9305 S NORTHSHORE DR
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City | KNOXVILLE
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State | TN
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Zip | 37922-6548
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Country | US
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Telephone | 865-670-7577
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Fax | 865-670-6686
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Authorized Official
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Title or Position | OWNER/TREATING PHYSICIAN
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Name | LARRY S. LITRAKIS
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Credential | D.C.
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Telephone | 865-670-7577
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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 | 758
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License Number State | TN
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