Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 3214 | TN |
NPI | 1003454752 |
---|---|
Provider Name | Garrin Scott Dotson |
First Address | Mount Juliet, TN 37122-2865 |
Second Address | Mount Juliet, TN 37122-2865 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/12/2019 |
Last Update Date | 12/12/2019 |