Detweiler Chiropractic Health Services of TN, PLLC

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

2894 Issued in TN

Legal business name

DETWEILER CHIROPRACTIC HEALTH SERVICES OF TN, PLLC

Doing business as

Mid-South Spine and Sports Performance

Practice address

556 Trinity Creek CV
Cordova, TN 38018-2279

Phone

(901) 573-2526

Fax

(901) 614-2523

NPI assigned

Jun 10, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Tyrel Detweiler, D.C.

Title

Owner/Chiropractic Physician

Phone

(901) 573-2526

Specialties & licenses 1

Addresses

Other names 1

• Mid-South Spine and Sports Performance Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1465516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491436800000",
    "number": "1548619497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9740 ROYAL CHARTRES SQ N",
            "address_2": "#201",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380184423",
            "telephone_number": "901-573-2526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "556 TRINITY CREEK CV",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380182279",
            "telephone_number": "901-573-2526",
            "fax_number": "901-614-2523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DETWEILER CHIROPRACTIC HEALTH SERVICES OF TN, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-10",
        "last_updated": "2017-04-06",
        "status": "A",
        "authorized_official_last_name": "DETWEILER",
        "authorized_official_first_name": "TYREL",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTIC PHYSICIAN",
        "authorized_official_telephone_number": "901-573-2526",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": "TN",
            "license": "2894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mid-South Spine and Sports Performance",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Sports Physician Chiropractor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.