Provider Demographics
NPI:1164712618
Name:JUSTIN ARD DC PLLC
Entity type:Organization
Organization Name:JUSTIN ARD DC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:K
Authorized Official - Last Name:ARD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:615-445-7701
Mailing Address - Street 1:104 EASTPARK DR STE 102
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-7535
Mailing Address - Country:US
Mailing Address - Phone:615-445-7701
Mailing Address - Fax:615-445-7771
Practice Address - Street 1:104 EASTPARK DR STE 102
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-7535
Practice Address - Country:US
Practice Address - Phone:615-445-7701
Practice Address - Fax:615-445-7771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-18
Last Update Date:2020-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000002486111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty