Organization
SPINE STOP PORTLAND, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GRANT G WATKINS II D.C. (MEMBER)
(270) 237-3304
Entity
Organization
Contact information
Practice address
305 S BROADWAY ST, PORTLAND, TN 37148-1413
(270) 237-3304
(270) 237-3305
Mailing address
352 OLD GALLATIN RD, SCOTTSVILLE, KY 42164-8666
(270) 237-3304
(270) 237-3305
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2848
TN
Other
Enumeration date
09/20/2016
Last updated
09/20/2016
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