Provider Demographics
NPI:1427584655
Name:MIDTENN CHIROPRACTIC SERVICES
Entity Type:Organization
Organization Name:MIDTENN CHIROPRACTIC SERVICES
Other - Org Name:ART OF LIFE CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JORDAN
Authorized Official - Middle Name:
Authorized Official - Last Name:QUINT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-217-0521
Mailing Address - Street 1:PO BOX 222
Mailing Address - Street 2:
Mailing Address - City:EAGLEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37060-0222
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7149 NOLENSVILLE RD
Practice Address - Street 2:SUITE A
Practice Address - City:NOLENSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37135-9461
Practice Address - Country:US
Practice Address - Phone:615-819-0587
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-09
Last Update Date:2017-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2438111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty