Provider Demographics
NPI:1417414335
Name:RED OWL INDUSTRIES, LLC
Entity Type:Organization
Organization Name:RED OWL INDUSTRIES, LLC
Other - Org Name:THE ALLERGY & SPINE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:
Authorized Official - Last Name:BOWERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-991-3100
Mailing Address - Street 1:16 EXECUTIVE PARK DR STE 100
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-3498
Mailing Address - Country:US
Mailing Address - Phone:615-991-3100
Mailing Address - Fax:615-991-3111
Practice Address - Street 1:16 EXECUTIVE PARK DR # 100
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075
Practice Address - Country:US
Practice Address - Phone:615-398-0148
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-27
Last Update Date:2019-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1417414335OtherTYPE 2 NPI ROI
TN1023417789OtherTYPE 1 NPI