Provider Demographics
NPI:1477581023
Name:HOLISTIC CHIROPRACTIC CENTER
Entity Type:Organization
Organization Name:HOLISTIC CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAKARIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:865-988-9815
Mailing Address - Street 1:603 HIGHWAY 321 N
Mailing Address - Street 2:BLDG 3 STE 201
Mailing Address - City:LENOIR CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37771-6575
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:603 HIGHWAY 321 N
Practice Address - Street 2:BLDG 3 STE 201
Practice Address - City:LENOIR CITY
Practice Address - State:TN
Practice Address - Zip Code:37771-6575
Practice Address - Country:US
Practice Address - Phone:865-988-9815
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty