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General NPI Number Information
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NPI Number | 1346420411
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Entity Type | Organization
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Legal Business Name | FAMILY CHIROPRACTIC PC
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Dates
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Enumeration Date | 11/06/2007
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Last Update Date | 01/23/2019
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Provider Practice Location Address
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Address Line | 136 WILSON PIKE CIR
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City | BRENTWOOD
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State | TN
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Zip | 37027-5280
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Country | US
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Telephone | 615-373-7009
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Fax |
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Provider Business Mailing Address
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Address Line | 136 WILSON PIKE CIR
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City | BRENTWOOD
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State | TN
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Zip | 37027-5280
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Country | US
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Telephone | 615-373-7009
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Fax | 675-373-7090
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Authorized Official
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Title or Position | OWNER
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Name | JENNIFER BETT GRAY
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Credential | DC
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Telephone | 615-373-7009
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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 |
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License Number State |
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