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General NPI Number Information
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NPI Number | 1326755034
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Entity Type | Organization
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Legal Business Name | NC BRENTWOOD LLC
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Dates
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Enumeration Date | 11/02/2022
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Last Update Date | 02/13/2023
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Provider Practice Location Address
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Address Line | 7127 CROSSROADS BLVD STE 103
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City | BRENTWOOD
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State | TN
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Zip | 37027-2827
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Country | US
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Telephone | 615-750-2311
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Fax | 618-607-8410
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Provider Business Mailing Address
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Address Line | 7127 CROSSROADS BLVD STE 103
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City | BRENTWOOD
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State | TN
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Zip | 37027-2827
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | STEVEN JACHINO
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Credential | DC
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Telephone | 618-718-1179
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 202D00000X
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Taxonomy Name | Integrative Medicine Physician
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License Number |
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License Number State |
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