Provider Demographics
NPI:1063879740
Name:NEUROGENX NERVE CENTER OF BRENTWOOD
Entity type:Organization
Organization Name:NEUROGENX NERVE CENTER OF BRENTWOOD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:M
Authorized Official - Last Name:BEGLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC,CFMP
Authorized Official - Phone:629-888-9151
Mailing Address - Street 1:1177 OLD HICKORY BLVD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-4241
Mailing Address - Country:US
Mailing Address - Phone:629-888-9151
Mailing Address - Fax:
Practice Address - Street 1:1177 OLD HICKORY BLVD
Practice Address - Street 2:SUITE 203
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-4241
Practice Address - Country:US
Practice Address - Phone:629-888-9151
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-26
Last Update Date:2016-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2795111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty