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General NPI Number Information
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NPI Number | 1619012507
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Entity Type | Organization
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Legal Business Name | WOODROW W GWINN JR
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Dates
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Enumeration Date | 02/20/2007
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Last Update Date | 05/21/2020
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Provider Practice Location Address
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Address Line | 259 N PETERS RD SUITE 101
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City | KNOXVILLE
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State | TN
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Zip | 37923-4923
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Country | US
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Telephone | 865-690-6898
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Fax | 865-690-9481
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Provider Business Mailing Address
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Address Line | 1812 E LAMAR ALEXANDER PKWY
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City | MARYVILLE
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State | TN
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Zip | 37804-5283
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Country | US
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Telephone | 865-977-0916
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Fax | 865-984-3519
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Authorized Official
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Title or Position | OWNER
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Name | DR. WOODROW W GWINN JR
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Credential | DC
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Telephone | 865-977-0916
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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 | DC0000000336
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License Number State | TN
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