Provider Demographics
NPI:1477736460
Name:HENDERSONVILLE CHIROPRACTIC
Entity Type:Organization
Organization Name:HENDERSONVILLE CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:BUTTS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:615-822-5222
Mailing Address - Street 1:102 GLEN OAK BLVD # A
Mailing Address - Street 2:SUITE 60
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-3069
Mailing Address - Country:US
Mailing Address - Phone:615-822-5222
Mailing Address - Fax:
Practice Address - Street 1:102 GLEN OAK BLVD # A
Practice Address - Street 2:SUITE 60
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-3069
Practice Address - Country:US
Practice Address - Phone:615-822-5222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-12
Last Update Date:2007-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC0000002206111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty