Provider Demographics
NPI:1891191136
Name:GANT, CALLIE (DC)
Entity Type:Individual
Prefix:
First Name:CALLIE
Middle Name:
Last Name:GANT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2823 BRANSFORD AVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37204-3101
Mailing Address - Country:US
Mailing Address - Phone:615-953-7544
Mailing Address - Fax:888-557-2195
Practice Address - Street 1:2823 BRANSFORD AVE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37204-3101
Practice Address - Country:US
Practice Address - Phone:615-953-7544
Practice Address - Fax:888-557-2195
Is Sole Proprietor?:No
Enumeration Date:2014-11-14
Last Update Date:2014-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2665111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor