Provider Demographics
NPI:1588400352
Name:GAMMILL, CHARLES ZACHARY (DC)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:ZACHARY
Last Name:GAMMILL
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 1:2616 PENNINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37216-3811
Mailing Address - Country:US
Mailing Address - Phone:720-278-1807
Mailing Address - Fax:
Practice Address - Street 1:324 LONG HOLLOW PIKE STE 205
Practice Address - Street 2:
Practice Address - City:GOODLETTSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37072-1853
Practice Address - Country:US
Practice Address - Phone:615-656-3498
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-02
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3760111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor