Provider Demographics
NPI:1790113546
Name:ON THE RIVER CHIROPRACTIC CLINIC PC
Entity Type:Organization
Organization Name:ON THE RIVER CHIROPRACTIC CLINIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVY
Authorized Official - Middle Name:L
Authorized Official - Last Name:ADDISON
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:615-977-0322
Mailing Address - Street 1:6600 NEW NASHVILLE HWY
Mailing Address - Street 2:SUITE 140
Mailing Address - City:SMYRNA
Mailing Address - State:TN
Mailing Address - Zip Code:37167-4663
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6600 NEW NASHVILLE HWY
Practice Address - Street 2:SUITE 140
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-4663
Practice Address - Country:US
Practice Address - Phone:615-977-0322
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-14
Last Update Date:2013-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty