1396866463 NPI number — ADAMSVILLE CHIROPRACTIC CENTER INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396866463 NPI number — ADAMSVILLE CHIROPRACTIC CENTER INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADAMSVILLE CHIROPRACTIC CENTER INC
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:
Provider Other Organization Name Type Code:
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:
1396866463
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2010 PATTON CHAPEL RD STE 201
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOOVER
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35216-5784
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
205-822-3333
Provider Business Mailing Address Fax Number:
205-822-0899

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2010 PATTON CHAPEL RD STE 201
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOOVER
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35216-5784
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-822-3333
Provider Business Practice Location Address Fax Number:
205-822-0899
Provider Enumeration Date:
04/03/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ELLIOTT
Authorized Official First Name:
TAMMY
Authorized Official Middle Name:
PATRICIA
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
205-822-3333

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  1010 , 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)