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General NPI Number Information
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NPI Number | 1942031372
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Entity Type | Organization
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Legal Business Name | BODY MIND REALIGN INC
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Dates
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Enumeration Date | 08/08/2024
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Last Update Date | 08/08/2024
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Provider Practice Location Address
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Address Line | 7423 S NORTHSHORE DR
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City | KNOXVILLE
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State | TN
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Zip | 37919-8823
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Country | US
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Telephone | 865-455-1750
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Fax | 865-305-8889
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Provider Business Mailing Address
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Address Line | 5107 SHADY DELL TRL
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City | KNOXVILLE
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State | TN
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Zip | 37914-5178
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Country | US
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Telephone | 310-733-7101
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Fax | 865-305-8889
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Authorized Official
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Title or Position | OWNER
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Name | DR. JANE GEORGE
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Credential | DC
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Telephone | 310-733-7101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NN1001X
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Taxonomy Name | Nutrition Chiropractor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 111NP0017X
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Taxonomy Name | Pediatric Chiropractor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 111NI0900X
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Taxonomy Name | Internist Chiropractor
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License Number |
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License Number State |
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