Provider Demographics
NPI:1831669704
Name:SPINE CHIROPRACTIC, PLLC
Entity Type:Organization
Organization Name:SPINE CHIROPRACTIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:M
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:706-581-3465
Mailing Address - Street 1:6711 MOUNTAIN VIEW RD STE 115
Mailing Address - Street 2:
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-6667
Mailing Address - Country:US
Mailing Address - Phone:423-541-7700
Mailing Address - Fax:423-541-7702
Practice Address - Street 1:6711 MOUNTAIN VIEW RD STE 115
Practice Address - Street 2:
Practice Address - City:OOLTEWAH
Practice Address - State:TN
Practice Address - Zip Code:37363-6667
Practice Address - Country:US
Practice Address - Phone:423-541-7700
Practice Address - Fax:423-541-7702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-04
Last Update Date:2019-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty