Provider Demographics
NPI:1053956599
Name:DAHLBERG, ADAM MATTHEW (DC)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:MATTHEW
Last Name:DAHLBERG
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 1:9325 APISON PIKE STE 137
Mailing Address - Street 2:
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-3805
Mailing Address - Country:US
Mailing Address - Phone:423-619-8005
Mailing Address - Fax:
Practice Address - Street 1:9325 APISON PIKE STE 137
Practice Address - Street 2:
Practice Address - City:OOLTEWAH
Practice Address - State:TN
Practice Address - Zip Code:37363-3805
Practice Address - Country:US
Practice Address - Phone:423-619-8005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-07
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000003317111N00000X
VA0104557422111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor