Organization
VITALE CHIROPRACTIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN VITALE (OWNER)
(731) 664-7935
Entity
Organization
Contact information
Practice address
1047 UNION UNIVERSITY DR, JACKSON, TN 38305-3655
(731) 664-7935
Mailing address
1047 UNION UNIVERSITY DR, JACKSON, TN 38305-3655
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC0000000826
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3676493
MEDICARE PROVIDER NUMBER
—
Enumeration date
10/05/2012
Last updated
10/05/2012
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