Organization
ELK RIVER CHIROPRACTIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK TYLER EDGE CHIROPRACTOR (DOCTOR/OWNER)
(904) 521-6349
Entity
Organization
Contact information
Practice address
105 DAVIDSON ST E, FAYETTEVILLE, TN 37334-3580
(931) 557-5111
(931) 967-5112
Mailing address
105 DAVIDSON ST E, FAYETTEVILLE, TN 37334-3580
(931) 557-5111
(931) 557-5112
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1831634542
NPI
TN
Enumeration date
07/16/2021
Last updated
08/03/2021
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