MEDICARE: CRIST CHIROPRACTIC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	2489	TN
2	111N00000X	Chiropractor	1254	TN

General Provider Information

NPI Number	:	1023302429
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CRIST CHIROPRACTIC

Provider Business Mailing Address
First Line	:	2025 MALLORY LANE
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37067
Country	:	US
Telephone Number	:	615-771-0022
Fax Number	:	615-771-0148

Provider Business Practice Location Address
First Line	:	2025 MALLORY LANE
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37067
Country	:	US
Telephone Number	:	615-771-0022
Fax Number	:	615-771-0148

Authorized Official
Title or Position	:	OWNER
Name	:	JASON CRIST
Credential	:
Telephone Number	:	615-414-5717

Provider Enumeration Date	:	06/02/2011
Last Update Date	:	07/07/2016

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Directions to “CRIST CHIROPRACTIC ” Practice Location

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