Provider Demographics
NPI:1336661230
Name:VELTUM, COREY (DC)
Entity Type:Individual
Prefix:
First Name:COREY
Middle Name:
Last Name:VELTUM
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6410 CHARLOTTE PIKE STE 102
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37209-2970
Mailing Address - Country:US
Mailing Address - Phone:615-724-6362
Mailing Address - Fax:615-356-4561
Practice Address - Street 1:6410 CHARLOTTE PIKE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37209-2970
Practice Address - Country:US
Practice Address - Phone:615-356-4656
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-12
Last Update Date:2017-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1092111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor