Provider Demographics
NPI:1639362031
Name:MOUNTAIN VIEW CHIROPRACTIC
Entity Type:Organization
Organization Name:MOUNTAIN VIEW CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:J
Authorized Official - Last Name:BEIGHLE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:865-579-4066
Mailing Address - Street 1:216 PHOENIX CT STE B
Mailing Address - Street 2:
Mailing Address - City:SEYMOUR
Mailing Address - State:TN
Mailing Address - Zip Code:37865-3914
Mailing Address - Country:US
Mailing Address - Phone:865-579-4066
Mailing Address - Fax:865-579-4065
Practice Address - Street 1:216 PHOENIX CT STE B
Practice Address - Street 2:
Practice Address - City:SEYMOUR
Practice Address - State:TN
Practice Address - Zip Code:37865-3914
Practice Address - Country:US
Practice Address - Phone:865-579-4066
Practice Address - Fax:865-579-4065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-20
Last Update Date:2007-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1967111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3728909Medicare PIN