Provider Demographics
NPI:1730285024
Name:DONALD R. SHELBY TOTAL HEALTH CONNECTION
Entity Type:Organization
Organization Name:DONALD R. SHELBY TOTAL HEALTH CONNECTION
Other - Org Name:TOTAL HEALTH CONNECTION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:SHELBY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:423-396-2100
Mailing Address - Street 1:9413 APISON PIKE
Mailing Address - Street 2:SUITE 108
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-8661
Mailing Address - Country:US
Mailing Address - Phone:423-396-2100
Mailing Address - Fax:423-396-2670
Practice Address - Street 1:9413 APISON PIKE
Practice Address - Street 2:SUITE 108
Practice Address - City:OOLTEWAH
Practice Address - State:TN
Practice Address - Zip Code:37363-8661
Practice Address - Country:US
Practice Address - Phone:423-396-2100
Practice Address - Fax:423-396-2670
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC0000001322111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN004120171OtherBCBS
TN3678630Medicare ID - Type Unspecified
TN004120171OtherBCBS