Provider Demographics
NPI:1306895743
Name:BOZZONE, MICHAEL B (DC)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:B
Last Name:BOZZONE
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 1:7000 LEE HWY
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-6735
Mailing Address - Country:US
Mailing Address - Phone:423-954-9166
Mailing Address - Fax:423-892-0184
Practice Address - Street 1:7000 LEE HIGHWAY
Practice Address - Street 2:STE.,900
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421
Practice Address - Country:US
Practice Address - Phone:423-954-9166
Practice Address - Fax:423-892-0184
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC000000000001794111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor