1700269438 NPI number — HEALING HANDS CHIROPRACTIC LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700269438 NPI number — HEALING HANDS CHIROPRACTIC LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEALING HANDS CHIROPRACTIC LLC
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:
1700269438
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/22/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
151 HERITAGE PARK DR
Provider Second Line Business Mailing Address:
SUITE 401
Provider Business Mailing Address City Name:
MURFREESBORO
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37129-0505
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-203-3505
Provider Business Mailing Address Fax Number:
615-203-3513

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
151 HERITAGE PARK DR
Provider Second Line Business Practice Location Address:
SUITE 401
Provider Business Practice Location Address City Name:
MURFREESBORO
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37129-0505
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-203-3505
Provider Business Practice Location Address Fax Number:
615-203-3513
Provider Enumeration Date:
06/30/2015

Additional Information

Authorized Official

Authorized Official Last Name:
BAES
Authorized Official First Name:
AMANDA
Authorized Official Middle Name:
DEE
Authorized Official Title or Position:
MEMBER MANAGER
Authorized Official Telephone Number:
615-203-3505

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  2784 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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