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General NPI Number Information
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NPI Number | 1437466877
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Entity Type | Organization
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Legal Business Name | ECKERT CHIROPRACTIC CENTER
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Dates
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Enumeration Date | 09/07/2010
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Last Update Date | 11/13/2015
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Provider Practice Location Address
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Address Line | 1062 OAK RIDGE TPKE STE B
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City | OAK RIDGE
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State | TN
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Zip | 37830-6479
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Country | US
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Telephone | 865-220-8499
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Fax |
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Provider Business Mailing Address
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Address Line | 1062 OAK RIDGE TPKE STE B
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City | OAK RIDGE
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State | TN
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Zip | 37830-6479
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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 | CLARK RAYMOND ECKERT
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Credential | D.C
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Telephone | 865-220-8499
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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 | 2431T
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License Number State | TN
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