Organization
BIRDWELL CHIROPRACTIC CLINIC, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH C. BIRDWELL D.C. (REGISTERED AGENT)
(865) 982-0802
Entity
Organization
Contact information
Practice address
729 W LAMAR ALEXANDER PKWY, MARYVILLE, TN 37801-3945
(865) 982-0802
(865) 984-2225
Mailing address
729 W LAMAR ALEXANDER PKWY, MARYVILLE, TN 37801-3945
(865) 982-0802
(865) 984-2225
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC0000000136
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1507486
—
TN
01
—
350042873
RAILROAD MEDICARE
TN
01
—
4146350
BCBST
TN
01
—
4440144
UNITED HEALTHCARE
TN
01
—
4486027
AETNA
TN
01
—
AETNA
4482807
TN
Enumeration date
06/14/2007
Last updated
11/06/2008
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