Provider Demographics
NPI:1740499615
Name:APPALACHIAN CHIROPRACTIC, P.C.
Entity type:Organization
Organization Name:APPALACHIAN CHIROPRACTIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:REGENIA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOWERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-245-6189
Mailing Address - Street 1:205 E SULLIVAN ST
Mailing Address - Street 2:
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37660-4328
Mailing Address - Country:US
Mailing Address - Phone:423-245-6189
Mailing Address - Fax:423-378-4837
Practice Address - Street 1:205 E SULLIVAN ST
Practice Address - Street 2:
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37660-4328
Practice Address - Country:US
Practice Address - Phone:423-245-6189
Practice Address - Fax:423-378-4837
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2011-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
U73575Medicare UPIN
TN3970230Medicare ID - Type Unspecified
TNT74793Medicare UPIN
TN37677823Medicare ID - Type Unspecified
TN3671545Medicare ID - Type Unspecified