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General NPI Number Information
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NPI Number | 1891998274
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Entity Type | Organization
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Legal Business Name | COOKEVILLE CHIROPRACTIC & PHYSICAL THERAPY, P. C.
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Dates
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Enumeration Date | 06/06/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 132 S LOWE AVE
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City | COOKEVILLE
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State | TN
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Zip | 38501-4701
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Country | US
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Telephone | 931-526-3151
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Fax |
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Provider Business Mailing Address
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Address Line | 132 S LOWE AVE
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City | COOKEVILLE
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State | TN
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Zip | 38501-4701
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Country | US
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Telephone | 931-526-3151
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Fax |
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Authorized Official
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Title or Position | SEC. TRES.
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Name | MRS. PAMELA D SCHMITT-MATZEN
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Credential | PT
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Telephone | 931-528-6037
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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 | DC0000000407
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License Number State | TN
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