Provider Demographics
NPI:1043271349
Name:TWILLEY, DANNY RAY (DC)
Entity Type:Individual
Prefix:DR
First Name:DANNY
Middle Name:RAY
Last Name:TWILLEY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4830 HIGHWAY 58
Mailing Address - Street 2:SUITE 14
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37416-1840
Mailing Address - Country:US
Mailing Address - Phone:423-899-6941
Mailing Address - Fax:423-499-8753
Practice Address - Street 1:4830 HIGHWAY 58
Practice Address - Street 2:SUITE 14
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37416-1840
Practice Address - Country:US
Practice Address - Phone:423-899-6941
Practice Address - Fax:423-499-8753
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-28
Last Update Date:2014-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN285111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0900XChiropractic ProvidersChiropractorInternist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN303-4121OtherBLUE CROSS
TN3672736Medicaid
TN58-1482894OtherTIN NUMBER
TNT74937Medicare UPIN
TN3672736Medicaid