Provider Demographics
NPI:1891199071
Name:MIDDLE TENNESSEE CHIROPRACTIC AND SPORTS INJURY, PLLC
Entity Type:Organization
Organization Name:MIDDLE TENNESSEE CHIROPRACTIC AND SPORTS INJURY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ELSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC, MS
Authorized Official - Phone:937-564-0931
Mailing Address - Street 1:9927 SAM DONALD CT STE D
Mailing Address - Street 2:
Mailing Address - City:NOLENSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37135-9413
Mailing Address - Country:US
Mailing Address - Phone:937-564-0931
Mailing Address - Fax:
Practice Address - Street 1:9927 SAM DONALD CT STE D
Practice Address - Street 2:
Practice Address - City:NOLENSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37135-9413
Practice Address - Country:US
Practice Address - Phone:937-564-0931
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-16
Last Update Date:2014-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2581111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty