Provider Demographics
NPI:1083628432
Name:MCELRATH, BERNASUE VALERIE (DC)
Entity Type:Individual
Prefix:DR
First Name:BERNASUE
Middle Name:VALERIE
Last Name:MCELRATH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:SUE
Other - Middle Name:V
Other - Last Name:MCELRATH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:37 S WILSON AVE
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38012
Mailing Address - Country:US
Mailing Address - Phone:731-779-9222
Mailing Address - Fax:
Practice Address - Street 1:37 S WILSON AVE
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38012
Practice Address - Country:US
Practice Address - Phone:731-779-9222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2009-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC1554111N00000X
ARDC1511111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3970597Medicaid
TN3970597Medicaid
TNU76603Medicare UPIN