Provider Demographics
NPI:1053680538
Name:DR. DAVID MARK ALLEN PC
Entity Type:Organization
Organization Name:DR. DAVID MARK ALLEN PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR /OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC,
Authorized Official - Phone:931-542-9420
Mailing Address - Street 1:625 N RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37040-3127
Mailing Address - Country:US
Mailing Address - Phone:931-542-9420
Mailing Address - Fax:
Practice Address - Street 1:625 N RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37040-3127
Practice Address - Country:US
Practice Address - Phone:931-542-9420
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-29
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3926104111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty