Provider Demographics
NPI:1972051704
Name:VUKOVIC, DUSTIN (DC)
Entity Type:Individual
Prefix:
First Name:DUSTIN
Middle Name:
Last Name:VUKOVIC
Suffix:
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 1:204 IRIS DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-2206
Mailing Address - Country:US
Mailing Address - Phone:615-826-5554
Mailing Address - Fax:
Practice Address - Street 1:2618 GALLATIN PIKE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37216-3740
Practice Address - Country:US
Practice Address - Phone:615-730-9430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-21
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC0000002982111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor