Provider Demographics
NPI:1295107613
Name:CHIRO2MED OF TENNESSEE
Entity type:Organization
Organization Name:CHIRO2MED OF TENNESSEE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MITCHELL
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-526-4084
Mailing Address - Street 1:750 E SPRING ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38501-4527
Mailing Address - Country:US
Mailing Address - Phone:931-526-4084
Mailing Address - Fax:931-526-6801
Practice Address - Street 1:750 E SPRING ST
Practice Address - Street 2:SUITE D
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-4527
Practice Address - Country:US
Practice Address - Phone:931-526-4084
Practice Address - Fax:931-526-6801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-25
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty