Provider Demographics
NPI:1538384995
Name:CHAMBERLAIN CHIROPRACTIC CLINIC INC
Entity type:Organization
Organization Name:CHAMBERLAIN CHIROPRACTIC CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR AND PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:CHAMBERLAIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:865-687-0474
Mailing Address - Street 1:4409 CENTRAL AVE PK
Mailing Address - Street 2:STE 102
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37912
Mailing Address - Country:US
Mailing Address - Phone:865-687-0474
Mailing Address - Fax:865-687-6333
Practice Address - Street 1:4409 CENTRAL AVE PK
Practice Address - Street 2:SUITE 102
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37912
Practice Address - Country:US
Practice Address - Phone:865-687-0474
Practice Address - Fax:865-687-6333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC0000000110111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty