Organization Name: | DYNAMIC HEALING LLC |
NPI Number: | 1548535842 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CHRISTOPHER F STANDLEY (OWNER) |
Mailing Address: | 1820 Haynes St Clarksville |
State: | TN US |
Postal Code: | 370434547 |
Phone Number: | 9312451500 |
Fax Number: | 9312451544 |
NPI Enumeration Date: | 03/20/2012 |
NPI Last Update Date: | 07/28/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 1511 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |