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General NPI Number Information
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NPI Number | 1902783970
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Entity Type | Organization
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Legal Business Name | WILD BLOOM CHIROPRACTIC LLC
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Dates
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Enumeration Date | 08/20/2025
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Last Update Date | 08/20/2025
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Provider Practice Location Address
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Address Line | 156 N WATER AVE STE B
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City | GALLATIN
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State | TN
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Zip | 37066-2871
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Country | US
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Telephone | 615-675-4273
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Fax | 615-989-2515
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Provider Business Mailing Address
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Address Line | 1117 WYNNEWOOD DR
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City | CASTALIAN SPRINGS
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State | TN
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Zip | 37031-4831
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Country | US
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Telephone | 405-464-7082
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Fax | 615-989-2515
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Authorized Official
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Title or Position | OWNER
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Name | BRANDI HUTCHISON-SLOANE
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Credential | DC
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Telephone | 615-675-4273
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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 |
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License Number State |
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