Provider Demographics
NPI:1457696569
Name:POWER CHIROPRACTIC
Entity type:Organization
Organization Name:POWER CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MYLES
Authorized Official - Middle Name:A
Authorized Official - Last Name:CRAWFORD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:615-227-5020
Mailing Address - Street 1:4117 GALLATIN PIKE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37216-2109
Mailing Address - Country:US
Mailing Address - Phone:615-227-5020
Mailing Address - Fax:615-262-2869
Practice Address - Street 1:4117 GALLATIN ROAD
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37216
Practice Address - Country:US
Practice Address - Phone:615-227-5020
Practice Address - Fax:615-262-2869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-29
Last Update Date:2012-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC0000001522111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3970634Medicare UPIN