=====================================================
General NPI Number Information
=====================================================
NPI Number | 1730042714
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PERFECTLY TUNED CHIROPRACTIC PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/05/2025
-----------------------------------------------------
Last Update Date | 12/05/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 801 E WATAUGA AVE
-----------------------------------------------------
City | JOHNSON CITY
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37601-4113
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 423-929-3700
-----------------------------------------------------
Fax | 423-929-8780
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 801 E WATAUGA AVE
-----------------------------------------------------
City | JOHNSON CITY
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37601-4113
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 423-929-3700
-----------------------------------------------------
Fax | 423-929-8780
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MEMBER
-----------------------------------------------------
Name | DR. JAMES SHANNON
-----------------------------------------------------
Credential | DC
-----------------------------------------------------
Telephone | 423-929-3700
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------