Provider Demographics
NPI:1417517814
Name:DYNAMIC CHIROPRACTIC CLINICS
Entity Type:Organization
Organization Name:DYNAMIC CHIROPRACTIC CLINICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:
Authorized Official - Last Name:BILLS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:615-907-7400
Mailing Address - Street 1:241 W NORTHFIELD BLVD
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-1506
Mailing Address - Country:US
Mailing Address - Phone:615-907-7400
Mailing Address - Fax:615-907-7435
Practice Address - Street 1:220 VETERANS PKWY STE E
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37128-6436
Practice Address - Country:US
Practice Address - Phone:615-907-7400
Practice Address - Fax:615-907-7435
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DYNAMIC CHIROPRACTIC CLINICS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-06-18
Last Update Date:2019-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty