Provider Demographics
NPI:1194482497
Name:POWELL, KEVIN (DC)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:
Last Name:POWELL
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 1:725 E WOODLANDS TRL
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-7433
Mailing Address - Country:US
Mailing Address - Phone:615-590-9618
Mailing Address - Fax:615-590-9619
Practice Address - Street 1:1585 MALLORY LN STE 208
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-3035
Practice Address - Country:US
Practice Address - Phone:615-590-9618
Practice Address - Fax:615-590-9619
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-21
Last Update Date:2021-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000003437111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor