Provider Demographics
NPI:1124369376
Name:SUMNER CHIROPRACTIC
Entity Type:Organization
Organization Name:SUMNER CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CORY
Authorized Official - Middle Name:
Authorized Official - Last Name:CROWLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-264-8515
Mailing Address - Street 1:260 W MAIN ST
Mailing Address - Street 2:SUITE 211
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-3347
Mailing Address - Country:US
Mailing Address - Phone:615-264-8515
Mailing Address - Fax:615-264-8516
Practice Address - Street 1:260 W MAIN ST
Practice Address - Street 2:SUITE 211
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-3347
Practice Address - Country:US
Practice Address - Phone:615-264-8515
Practice Address - Fax:615-264-8516
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-13
Last Update Date:2013-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3973604OtherMEDICARE