Provider Demographics
NPI:1134197049
Name:MCPHERSON, ANGELA FREE (DC)
Entity type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:FREE
Last Name:MCPHERSON
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:PO BOX 3604
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37320-3604
Mailing Address - Country:US
Mailing Address - Phone:423-478-8989
Mailing Address - Fax:423-478-8992
Practice Address - Street 1:55 MOUSE CREEK RD NW
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37312-4840
Practice Address - Country:US
Practice Address - Phone:423-479-8989
Practice Address - Fax:423-478-8992
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2014-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC-1054111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNP00232343OtherRAILROAD MEDICARE
TN4103176OtherBLUE CROSS BLUE SHIELD
TNU45811Medicare UPIN
TN6659230001Medicare NSC
TN3676963Medicare PIN
TNP00232343OtherRAILROAD MEDICARE