Organization Name: | LIFE SOURCE THE CREATING WELLNESS CENTER |
NPI Number: | 1073754032 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CHAD M UPCHURCH (OWNER) |
Mailing Address: | 491 Henslee Dr Dickson |
State: | TN US |
Postal Code: | 370552166 |
Phone Number: | 6154416115 |
Fax Number: | 6154415154 |
NPI Enumeration Date: | 03/20/2009 |
NPI Last Update Date: | 04/06/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | 1444 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Chiropractic Providers |
Taxonomy Classification: | Chiropractor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |