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General NPI Number Information
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NPI Number | 1568946465
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Entity Type | Organization
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Legal Business Name | BRENTWOOD ADVANCED CHIROPRACTIC LLC
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Dates
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Enumeration Date | 09/18/2018
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Last Update Date | 09/18/2018
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Provider Practice Location Address
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Address Line | 214 WARD CIR STE 800
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City | BRENTWOOD
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State | TN
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Zip | 37027-7566
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Country | US
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Telephone | 814-937-2869
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Fax |
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Provider Business Mailing Address
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Address Line | 5000 ARCHDALE DR APT 5202
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City | FRANKLIN
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State | TN
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Zip | 37064-1781
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Country | US
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Telephone | 814-937-2869
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Fax |
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Authorized Official
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Title or Position | DOCTOR OF CHIROPRACTIC
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Name | DR. JAMES PATRICK SHANNON JR.
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Credential | DC
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Telephone | 814-937-2869
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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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