Organization
SOUTHEAST SPINE & SPORTS MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TREVOR THOMPSON SHAW DC (OWNER / DOCTOR)
(386) 366-2153
Entity
Organization
Contact information
Practice address
1399 NO PONE VALLEY RD, GEORGETOWN, TN 37336-4846
(386) 366-2153
Mailing address
1399 NO PONE VALLEY RD, GEORGETOWN, TN 37336-4846
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2778
TN
Other
Enumeration date
03/20/2015
Last updated
09/18/2015
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