Provider Demographics
NPI:1205213113
Name:PREMIER CHIROPRACTIC
Entity Type:Organization
Organization Name:PREMIER CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTELIONE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:607-760-9985
Mailing Address - Street 1:2040 RESERVE BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:TN
Mailing Address - Zip Code:37174-2370
Mailing Address - Country:US
Mailing Address - Phone:615-653-4541
Mailing Address - Fax:
Practice Address - Street 1:2040 RESERVE BLVD STE A
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:TN
Practice Address - Zip Code:37174-2370
Practice Address - Country:US
Practice Address - Phone:615-653-4541
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-29
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2854111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN2855OtherNOT ENROLLED IN MEDICARE YET.
TN2854OtherNOT ENROLLED IN MEDICARE YET.