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General NPI Number Information
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NPI Number | 1891199071
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Entity Type | Organization
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Legal Business Name | MIDDLE TENNESSEE CHIROPRACTIC AND SPORTS INJURY, PLLC
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Dates
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Enumeration Date | 10/16/2014
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Last Update Date | 10/16/2014
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Provider Practice Location Address
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Address Line | 9927 SAM DONALD CT STE D
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City | NOLENSVILLE
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State | TN
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Zip | 37135-9413
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Country | US
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Telephone | 937-564-0931
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Fax |
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Provider Business Mailing Address
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Address Line | 9927 SAM DONALD CT STE D
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City | NOLENSVILLE
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State | TN
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Zip | 37135-9413
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Country | US
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Telephone | 937-564-0931
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Fax |
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Authorized Official
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Title or Position | OWNER/MEMBER
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Name | DR. JONATHAN ELSON
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Credential | D.C., M.S.
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Telephone | 937-564-0931
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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 | 2581
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License Number State | TN
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