=====================================================
General NPI Number Information
=====================================================
NPI Number | 1629347455
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PEARCE FAMILY CHIROPRACTIC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/22/2011
-----------------------------------------------------
Last Update Date | 12/22/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 268 BARFIELD CRESCENT RD SUITE J
-----------------------------------------------------
City | MURFREESBORO
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37128-2625
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 615-895-1202
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 332038
-----------------------------------------------------
City | MURFREESBORO
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37133-2038
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 615-895-1202
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. DAVID ALEXANDER PEARCE
-----------------------------------------------------
Credential | DC
-----------------------------------------------------
Telephone | 615-895-1202
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111NR0400X
-----------------------------------------------------
Taxonomy Name | Rehabilitation Chiropractor
-----------------------------------------------------
License Number | 1398
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------