Provider Demographics
NPI:1073271342
Name:TULLAHOMA SPINE & WELLNESS
Entity Type:Organization
Organization Name:TULLAHOMA SPINE & WELLNESS
Other - Org Name:FAMILY CHIROPRACTIC COMPLEX
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:FRANK
Authorized Official - Last Name:STABILE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:931-455-0408
Mailing Address - Street 1:111 MARBURY XING
Mailing Address - Street 2:
Mailing Address - City:TULLAHOMA
Mailing Address - State:TN
Mailing Address - Zip Code:37388-2215
Mailing Address - Country:US
Mailing Address - Phone:931-455-0408
Mailing Address - Fax:931-454-9377
Practice Address - Street 1:111 MARBURY XING
Practice Address - Street 2:
Practice Address - City:TULLAHOMA
Practice Address - State:TN
Practice Address - Zip Code:37388-2215
Practice Address - Country:US
Practice Address - Phone:931-455-0408
Practice Address - Fax:931-454-9377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-03
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Single Specialty