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ELK RIVER CHIROPRACTIC LLC NPI 1437721529


NPI Information

NPI: 1437721529
Provider Name: ELK RIVER CHIROPRACTIC LLC
Classification: Chiropractor - 111N00000X
Entity Type: Organization

CLIA Number: 44D0892022

Address:
105 DAVIDSON ST E
FAYETTEVILLE, TN
ZIP 37334
Phone: (931) 557-5111
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ELK RIVER CHIROPRACTIC LLC is a chiropractor in Fayetteville, TN. The provider is a provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. ELK RIVER CHIROPRACTIC LLC NPI is 1437721529. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

105 DAVIDSON ST E
FAYETTEVILLE, TN
ZIP 37334-580
Phone: (931) 557-5111
Fax: (931) 967-5112

The provider's authorized official is Mark Tyler Edge .
The authorized official title is Doctor/owner and has the following contact phone number (904) 521-6349.

The CLIA number assigned to this NPI record is 44D0892022 - skilled nursing facility/nursing facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/16/2021 and was last updated on 8/3/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1111N00000XChiropractorYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11831634542OTHERTENNESSEENPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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