Spine Stop Portland, Pllc

NPI #1659829562 in Portland, Tennessee

Provider Information

NPI Number: 1659829562
Entity Type: Organization
Organization Name: Spine Stop Portland, Pllc
Primary Specialty: Chiropractor
Enumeration Date: Sep 20, 2016
Last Updated: Sep 20, 2016

Practice Location

Address: 305 S BROADWAY ST
City: Portland
State: Tennessee
ZIP Code: 37148-1413
Phone: (270) 237-3304

Authorized Official

Name: DR. GRANT G WATKINS II, D.C.
Title: MEMBER
Phone: (270) 237-3304

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Chiropractor	111N00000X	Primary

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