Basic Information
| Provider Information | |||||||||
| NPI: | 1508988221 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CAMPBELL STATION CHIROPRACTIC PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 759 | ||||||||
| Address2: | 4910 COLUMBIA HWY STE 102 | ||||||||
| City: | SPRING HILL | ||||||||
| State: | TN | ||||||||
| PostalCode: | 371740759 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153021333 | ||||||||
| FaxNumber: | 6153023030 | ||||||||
| Practice Location | |||||||||
| Address1: | 4910 COLUMBIA PIKE | ||||||||
| Address2: | SUITE 102 | ||||||||
| City: | SPRING HILL | ||||||||
| State: | TN | ||||||||
| PostalCode: | 371744200 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153021333 | ||||||||
| FaxNumber: | 6153023030 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/04/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | MILANI | ||||||||
| AuthorizedOfficialFirstName: | MARIO | ||||||||
| AuthorizedOfficialMiddleName: | MARTIN | ||||||||
| AuthorizedOfficialTitleorPosition: | PARTNER | ||||||||
| AuthorizedOfficialTelephone: | 6153021333 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | DC | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 111N00000X | TN | Y | 193400000X SINGLE SPECIALTY GROUP | Chiropractic Providers | Chiropractor |
No ID Information.