Southeast Spine & Sports Medicine
Organization Active NPI Chiropractor · Georgetown, TN
NPI 1821482589 · NPPES record last updated Sep 18, 2015
Key facts
- NPI
- 1821482589
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- 2778 (TN)
- Legal business name
- SOUTHEAST SPINE & SPORTS MEDICINE
- Practice address
- 1399 No Pone Valley Rd
Georgetown, TN 37336-4846 - Phone
- (386) 366-2153
- NPI assigned
- Mar 20, 2015
- Organization subpart
- No
Authorized official
- Name
- Dr. Trevor Thompson Shaw, DC
- Title
- Owner / Doctor
- Phone
- (386) 366-2153
Practitioners 1
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | 2778 | TN | Yes |
Addresses
Primary practice location
1399 No Pone Valley Rd
Georgetown, TN 37336-4846
Mailing address
1399 No Pone Valley Rd
Georgetown, TN 37336-4846
Other providers in Georgetown, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 18, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.