Provider Demographics
NPI:1710059928
Name:UPCHURCH, CHAD MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:CHAD
Middle Name:MICHAEL
Last Name:UPCHURCH
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 1:491 HENSLEE DR
Mailing Address - Street 2:
Mailing Address - City:DICKSON
Mailing Address - State:TN
Mailing Address - Zip Code:37055-2166
Mailing Address - Country:US
Mailing Address - Phone:615-441-6115
Mailing Address - Fax:615-441-5154
Practice Address - Street 1:491 HENSLEE DR
Practice Address - Street 2:
Practice Address - City:DICKSON
Practice Address - State:TN
Practice Address - Zip Code:37055-2166
Practice Address - Country:US
Practice Address - Phone:615-441-6115
Practice Address - Fax:615-441-5154
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2016-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1444111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3972348Medicare ID - Type Unspecified
TNU69145Medicare UPIN