Provider Demographics
NPI:1396900502
Name:ACTION CHIROPRACTIC , LLC
Entity type:Organization
Organization Name:ACTION CHIROPRACTIC , LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYISICAN
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:CASEY
Authorized Official - Last Name:BEARDEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:615-356-4656
Mailing Address - Street 1:6410 CHARLOTTE PIKE STE 101
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37209-2970
Mailing Address - Country:US
Mailing Address - Phone:615-356-4656
Mailing Address - Fax:615-356-4561
Practice Address - Street 1:6410 CHARLOTTE PIKE STE 101
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37209-2970
Practice Address - Country:US
Practice Address - Phone:615-356-4656
Practice Address - Fax:615-356-4561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-28
Last Update Date:2010-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN00000001092111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3677245Medicare UPIN
TN3677255Medicare PIN