1215190194 NPI number — CHIROFIT, PLLC

Table of content: (NPI 1215190194)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215190194 NPI number — CHIROFIT, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHIROFIT, PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1215190194
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/05/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3326 ASPEN GROVE DR
Provider Second Line Business Mailing Address:
STE. 500
Provider Business Mailing Address City Name:
FRANKLIN
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37067-2837
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-771-0722
Provider Business Mailing Address Fax Number:
615-771-0734

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3326 ASPEN GROVE DR
Provider Second Line Business Practice Location Address:
STE. 500
Provider Business Practice Location Address City Name:
FRANKLIN
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37067-2837
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-771-0722
Provider Business Practice Location Address Fax Number:
615-771-0734
Provider Enumeration Date:
07/09/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
EVANS
Authorized Official First Name:
HUNTER
Authorized Official Middle Name:
ALLEN
Authorized Official Title or Position:
MEMBER
Authorized Official Telephone Number:
615-771-0722

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  2229 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 332BC3200X , with the licence number: 2229 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 4171555 . This is a "BCBST" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".