Provider Demographics
NPI:1225420888
Name:GENERATION CHIROPRACTIC
Entity Type:Organization
Organization Name:GENERATION CHIROPRACTIC
Other - Org Name:CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DEANDRA
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:HERNDON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:270-293-6285
Mailing Address - Street 1:179 HANCOCK ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:GALLATIN
Mailing Address - State:TN
Mailing Address - Zip Code:37066-6346
Mailing Address - Country:US
Mailing Address - Phone:615-527-7960
Mailing Address - Fax:615-527-7961
Practice Address - Street 1:179 HANCOCK ST STE 200
Practice Address - Street 2:
Practice Address - City:GALLATIN
Practice Address - State:TN
Practice Address - Zip Code:37066-6344
Practice Address - Country:US
Practice Address - Phone:615-527-7960
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-19
Last Update Date:2015-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2828111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty