1457428799 NPI number — DODD CHIROPRACTIC

Table of content: (NPI 1457428799)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457428799 NPI number — DODD CHIROPRACTIC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DODD CHIROPRACTIC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
TUGGLE CHIROPRACTIC CLINIC P.A.
Provider Other Organization Name Type Code:
4
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1457428799
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/14/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
525 MAIN AVE SW
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CULLMAN
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35055-4700
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
256-734-7315
Provider Business Mailing Address Fax Number:
256-739-4390

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
525 MAIN AVE SW
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CULLMAN
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35055-4700
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
256-734-7315
Provider Business Practice Location Address Fax Number:
256-739-4390
Provider Enumeration Date:
11/30/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SHIPP
Authorized Official First Name:
LEAH
Authorized Official Middle Name:
J
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
256-734-7315

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  9467 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 051070021 . This is a "PROVIDER NUMBER" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 051506982 . This is a "PROVIDER NUMBER" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 1639262355 . This is a "NPI" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 1366536310 . This is a "NPI" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".