Individual
DR. JERRY BAXTER SHACKELFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D. C.
Contact information
Practice address
521 E CAMPBELL RD, MADISON, TN 37115-2501
(615) 944-2305
(615) 868-2596
Mailing address
521 E CAMPBELL RD, MADISON, TN 37115-2501
(615) 944-2305
(615) 868-2596
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
00179
TN
Other
Enumeration date
03/21/2007
Last updated
07/08/2007
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