Provider Demographics
NPI:1750614491
Name:WESTMORELAND, LEE THOMAS (DC)
Entity type:Individual
Prefix:DR
First Name:LEE
Middle Name:THOMAS
Last Name:WESTMORELAND
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5617 HIGHWAY 153
Mailing Address - Street 2:SUITE 104
Mailing Address - City:HIXSON
Mailing Address - State:TN
Mailing Address - Zip Code:37343-4675
Mailing Address - Country:US
Mailing Address - Phone:423-875-8786
Mailing Address - Fax:423-875-5583
Practice Address - Street 1:5617 HIGHWAY 153
Practice Address - Street 2:SUITE 104
Practice Address - City:HIXSON
Practice Address - State:TN
Practice Address - Zip Code:37343-4675
Practice Address - Country:US
Practice Address - Phone:423-875-8786
Practice Address - Fax:423-875-5583
Is Sole Proprietor?:No
Enumeration Date:2009-09-14
Last Update Date:2013-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2551111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4318434OtherBLUECROSS BLUESHIELD