Provider Demographics
NPI:1437466877
Name:ECKERT CHIROPRACTIC CENTER
Entity Type:Organization
Organization Name:ECKERT CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CLARK
Authorized Official - Middle Name:RAYMOND
Authorized Official - Last Name:ECKERT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:865-220-8499
Mailing Address - Street 1:1062 OAK RIDGE TPKE STE B
Mailing Address - Street 2:
Mailing Address - City:OAK RIDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37830-6479
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1062 OAK RIDGE TPKE STE B
Practice Address - Street 2:
Practice Address - City:OAK RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37830-6479
Practice Address - Country:US
Practice Address - Phone:865-220-8499
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-07
Last Update Date:2015-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2431T111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty