Provider Demographics
NPI:1578804738
Name:JLWCHIRO-TN PLLC
Entity Type:Organization
Organization Name:JLWCHIRO-TN PLLC
Other - Org Name:WARD CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:LEONARD
Authorized Official - Last Name:WARLICK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:423-542-2913
Mailing Address - Street 1:851 W ELK AVE
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTON
Mailing Address - State:TN
Mailing Address - Zip Code:37643-2946
Mailing Address - Country:US
Mailing Address - Phone:423-542-2913
Mailing Address - Fax:423-542-3485
Practice Address - Street 1:851 W ELK AVE
Practice Address - Street 2:
Practice Address - City:ELIZABETHTON
Practice Address - State:TN
Practice Address - Zip Code:37643-2946
Practice Address - Country:US
Practice Address - Phone:423-542-2913
Practice Address - Fax:423-542-3485
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-12
Last Update Date:2013-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1056111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty