Provider Demographics
NPI:1235531203
Name:LONG HOLLOW CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:LONG HOLLOW CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:P
Authorized Official - Last Name:KOESTER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:615-851-3900
Mailing Address - Street 1:3050 BUSINESS PARK CIR STE 103
Mailing Address - Street 2:
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37072-3658
Mailing Address - Country:US
Mailing Address - Phone:615-851-3900
Mailing Address - Fax:615-851-3933
Practice Address - Street 1:3050 BUSINESS PARK CIR STE 103
Practice Address - Street 2:
Practice Address - City:GOODLETTSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37072-3658
Practice Address - Country:US
Practice Address - Phone:615-851-3900
Practice Address - Fax:615-851-3933
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-22
Last Update Date:2014-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2810111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty