Provider Demographics
NPI:1851611628
Name:SIMPLY CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:SIMPLY CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:BODKIN
Authorized Official - Suffix:
Authorized Official - Credentials:BS, DC
Authorized Official - Phone:423-475-5756
Mailing Address - Street 1:1963 NORTHPOINT BLVD
Mailing Address - Street 2:SUITE 109
Mailing Address - City:HIXSON
Mailing Address - State:TN
Mailing Address - Zip Code:37343-4631
Mailing Address - Country:US
Mailing Address - Phone:423-475-5756
Mailing Address - Fax:
Practice Address - Street 1:1963 NORTHPOINT BLVD
Practice Address - Street 2:SUITE 109
Practice Address - City:HIXSON
Practice Address - State:TN
Practice Address - Zip Code:37343-4631
Practice Address - Country:US
Practice Address - Phone:423-475-5756
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-03
Last Update Date:2010-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2412111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty