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NPI Code Detail

MEDICARE: CRUX CHIROPRACTIC

MEDICARE: CRUX 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
1111N00000XChiropractor

General Provider Information

NPI Number : 1558199885
Entity Type Code : Organization
Provider Name (Legal Business Name) : CRUX CHIROPRACTIC
Provider Business Mailing Address
First Line : 2433 BROAD ST # A
Second Line :
City : CHATTANOOGA
State : TN
Zip : 37408-2910
Country : US
Telephone Number : 423-287-3123
Fax Number :
Provider Business Practice Location Address
First Line : 2433 BROAD ST # A
Second Line :
City : CHATTANOOGA
State : TN
Zip : 37408-2910
Country : US
Telephone Number : 423-287-3123
Fax Number :
Authorized Official
Title or Position : DOCTOR OF CHIROPRACTIC
Name : DR. EVANA WATFA-ZINA MAKHOUL
Credential : DC
Telephone Number : 423-287-3123
Provider Enumeration Date : 07/26/2024
Last Update Date : 07/26/2024

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Directions to “CRUX CHIROPRACTIC ” Practice Location

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