Provider Demographics
NPI:1811023740
Name:RELIEF DOC SERVICES, INC
Entity Type:Organization
Organization Name:RELIEF DOC SERVICES, INC
Other - Org Name:RELIEF DOC HEALTH AND WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JACK
Authorized Official - Middle Name:L
Authorized Official - Last Name:NICKLE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:423-893-6602
Mailing Address - Street 1:7804 E BRAINERD RD STE F
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-3254
Mailing Address - Country:US
Mailing Address - Phone:423-893-6602
Mailing Address - Fax:423-485-9550
Practice Address - Street 1:7804 E BRAINERD RD STE F
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-3254
Practice Address - Country:US
Practice Address - Phone:423-893-6602
Practice Address - Fax:423-485-9550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2013-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No251B00000XAgenciesCase ManagementGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3370103Medicare PIN