Provider Demographics
NPI:1598176125
Name:WOLF, CAMERON (DC)
Entity Type:Individual
Prefix:
First Name:CAMERON
Middle Name:
Last Name:WOLF
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2441 OLD FORT PKWY STE E
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37128-4162
Mailing Address - Country:US
Mailing Address - Phone:615-216-0333
Mailing Address - Fax:615-216-0335
Practice Address - Street 1:2441 OLD FORT PKWY STE E
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37128-4162
Practice Address - Country:US
Practice Address - Phone:615-216-0333
Practice Address - Fax:615-216-0335
Is Sole Proprietor?:No
Enumeration Date:2014-05-16
Last Update Date:2016-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2953111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor