Provider Demographics
NPI:1710288980
Name:MESECK FAMILY CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:MESECK FAMILY CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED PUBLIC ACCOUNTANT
Authorized Official - Prefix:
Authorized Official - First Name:JIM
Authorized Official - Middle Name:
Authorized Official - Last Name:DURHAM
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:615-662-2808
Mailing Address - Street 1:865 BELLEVUE RD
Mailing Address - Street 2:APT. U2
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37221-2743
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:865 BELLEVUE RD
Practice Address - Street 2:APT. U2
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37221-2743
Practice Address - Country:US
Practice Address - Phone:815-483-1615
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-04
Last Update Date:2010-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2308261QH0100X
TN2322261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service