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NPI Code Detail

MEDICARE: NEW LIFE CHIROPRACTIC

MEDICARE: NEW LIFE 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
1111N00000XChiropractor2164TN

General Provider Information

NPI Number : 1720228885
Entity Type Code : Organization
Provider Name (Legal Business Name) : NEW LIFE CHIROPRACTIC
Provider Business Mailing Address
First Line : 1746 GENERAL GEORGE PATTON DR
Second Line : SUITE 102
City : BRENTWOOD
State : TN
Zip : 37027-2935
Country : US
Telephone Number : 615-221-8033
Fax Number :
Provider Business Practice Location Address
First Line : 1746 GENERAL GEORGE PATTON DR
Second Line : SUITE 102
City : BRENTWOOD
State : TN
Zip : 37027-2935
Country : US
Telephone Number : 615-221-8033
Fax Number :
Authorized Official
Title or Position : OWNER/SOLE PROPRIETOR
Name : DR. DIONNE YVELLE KELLOGG
Credential : D.C.
Telephone Number : 615-221-8033
Provider Enumeration Date : 03/03/2009
Last Update Date : 03/03/2009

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Directions to “NEW LIFE CHIROPRACTIC ” Practice Location

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