Provider Demographics
NPI:1447317045
Name:WAYNE A POTTER DC PC
Entity type:Organization
Organization Name:WAYNE A POTTER DC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:A
Authorized Official - Last Name:POTTER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:615-895-1233
Mailing Address - Street 1:6711 MIDLAND RD
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANA
Mailing Address - State:TN
Mailing Address - Zip Code:37037-5311
Mailing Address - Country:US
Mailing Address - Phone:931-684-2926
Mailing Address - Fax:931-773-3033
Practice Address - Street 1:210 S MAIN ST # 1E
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37160-3906
Practice Address - Country:US
Practice Address - Phone:931-684-2926
Practice Address - Fax:931-773-3033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty