Provider Demographics
NPI:1942846928
Name:MCGUIRE, ALBERT THOMAS IV (DC)
Entity Type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:THOMAS
Last Name:MCGUIRE
Suffix:IV
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 S MOUNT JULIET RD
Mailing Address - Street 2:
Mailing Address - City:MT JULIET
Mailing Address - State:TN
Mailing Address - Zip Code:37122-6490
Mailing Address - Country:US
Mailing Address - Phone:586-489-4443
Mailing Address - Fax:
Practice Address - Street 1:650 S MOUNT JULIET RD
Practice Address - Street 2:
Practice Address - City:MT JULIET
Practice Address - State:TN
Practice Address - Zip Code:37122-6490
Practice Address - Country:US
Practice Address - Phone:586-489-4443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-25
Last Update Date:2019-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3247111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty