Provider Demographics
NPI:1144580408
Name:GUARDIAN CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:GUARDIAN CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:STOHR
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:615-822-7421
Mailing Address - Street 1:129 INDIAN LAKE ROAD
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075
Mailing Address - Country:US
Mailing Address - Phone:615-822-7421
Mailing Address - Fax:615-822-7475
Practice Address - Street 1:129 INDIAN LAKE RD
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-3820
Practice Address - Country:US
Practice Address - Phone:615-822-7421
Practice Address - Fax:615-822-7475
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-21
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2603111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty