Provider Demographics
NPI:1871703801
Name:CRUTCHFIELD, CHARLES DWAYNE (DC)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:DWAYNE
Last Name:CRUTCHFIELD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:519 DONELSON PIKE STE 107
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37214-3700
Mailing Address - Country:US
Mailing Address - Phone:615-889-2040
Mailing Address - Fax:615-889-1020
Practice Address - Street 1:519 DONELSON PIKE STE 107
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37214-3700
Practice Address - Country:US
Practice Address - Phone:615-889-2040
Practice Address - Fax:615-889-1020
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2010-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1839111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor