Provider Demographics
NPI:1518400506
Name:DON D DUFF DC DBA COLLEGEDALE CHIROPRACTIC
Entity Type:Organization
Organization Name:DON D DUFF DC DBA COLLEGEDALE CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DON
Authorized Official - Middle Name:D
Authorized Official - Last Name:DUFF
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:423-238-4118
Mailing Address - Street 1:9457 DAVID SMITH LN
Mailing Address - Street 2:SUITE 105
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-7292
Mailing Address - Country:US
Mailing Address - Phone:423-238-4118
Mailing Address - Fax:423-238-6565
Practice Address - Street 1:9457 DAVID SMITH LN
Practice Address - Street 2:SUITE 105
Practice Address - City:OOLTEWAH
Practice Address - State:TN
Practice Address - Zip Code:37363-7292
Practice Address - Country:US
Practice Address - Phone:423-238-4118
Practice Address - Fax:423-238-6565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-23
Last Update Date:2016-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN723111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty