Provider Demographics
NPI:1649410465
Name:HENDERSON COUNTY CLINIC OF CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:HENDERSON COUNTY CLINIC OF CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MERRILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:731-249-5640
Mailing Address - Street 1:16570 HIGHWAY 104 N
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:TN
Mailing Address - Zip Code:38351-3847
Mailing Address - Country:US
Mailing Address - Phone:731-249-5640
Mailing Address - Fax:
Practice Address - Street 1:16570 HIGHWAY 104 N
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:TN
Practice Address - Zip Code:38351-3847
Practice Address - Country:US
Practice Address - Phone:731-249-5640
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-06
Last Update Date:2009-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2323111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty