Provider Demographics
NPI:1679964035
Name:CARTHAGE FAMILY CHIROPRACTIC
Entity Type:Organization
Organization Name:CARTHAGE FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:615-735-9336
Mailing Address - Street 1:516 MAIN ST N
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37030-1210
Mailing Address - Country:US
Mailing Address - Phone:615-735-9336
Mailing Address - Fax:615-735-9336
Practice Address - Street 1:516 MAIN ST N
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:TN
Practice Address - Zip Code:37030-1210
Practice Address - Country:US
Practice Address - Phone:615-735-9336
Practice Address - Fax:615-735-9336
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-06
Last Update Date:2015-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2782111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty