Provider Demographics
NPI:1740881523
Name:MCGUIRE, MITCHELL CRAIG
Entity type:Individual
Prefix:MR
First Name:MITCHELL
Middle Name:CRAIG
Last Name:MCGUIRE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 WHITE BRIDGE PIKE STE 316
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-1467
Mailing Address - Country:US
Mailing Address - Phone:615-352-4455
Mailing Address - Fax:
Practice Address - Street 1:28 WHITE BRIDGE PIKE STE 316
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-1467
Practice Address - Country:US
Practice Address - Phone:615-352-4455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-06
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3321111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor