Provider Demographics
NPI:1639266364
Name:CHIROPRACTIC SERVICES INC
Entity Type:Organization
Organization Name:CHIROPRACTIC SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:
Authorized Official - Last Name:PLUZNYK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:865-982-4301
Mailing Address - Street 1:PO BOX 1122
Mailing Address - Street 2:
Mailing Address - City:ALCOA
Mailing Address - State:TN
Mailing Address - Zip Code:37701-1122
Mailing Address - Country:US
Mailing Address - Phone:865-982-4301
Mailing Address - Fax:865-982-4302
Practice Address - Street 1:2004 E BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37804-3033
Practice Address - Country:US
Practice Address - Phone:865-982-4301
Practice Address - Fax:865-982-4302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC0000001181111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNU58814Medicare UPIN