MEDICARE: BRIAN CHINN D.C.

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	2761	TN

General Provider Information

NPI Number	:	1124446174
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIAN CHINN D.C.

Provider Business Mailing Address
First Line	:	6011 CHESTERTON WAY STE 209
Second Line	:
City	:	OOLTEWAH
State	:	TN
Zip	:	37363-1523
Country	:	US
Telephone Number	:	423-355-5100
Fax Number	:	423-355-5101

Provider Business Practice Location Address
First Line	:	6011 CHESTERTON WAY STE 209
Second Line	:
City	:	OOLTEWAH
State	:	TN
Zip	:	37363-1523
Country	:	US
Telephone Number	:	423-355-5100
Fax Number	:	423-355-5101

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/06/2014
Last Update Date	:	08/17/2020

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