1609904234 NPI number — FRENCH CHIROPRACTIC AND WELLNESS SERVICES

Table of content: (NPI 1609904234)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609904234 NPI number — FRENCH CHIROPRACTIC AND WELLNESS SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FRENCH CHIROPRACTIC AND WELLNESS SERVICES
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:
6
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:
1609904234
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:
4898 VALLEYDALE RD
Provider Second Line Business Mailing Address:
SUITE A-4
Provider Business Mailing Address City Name:
BIRMINGHAM
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35242-4654
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
205-995-5078
Provider Business Mailing Address Fax Number:
205-995-5738

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4898 VALLEYDALE RD
Provider Second Line Business Practice Location Address:
SUITE A-4
Provider Business Practice Location Address City Name:
BIRMINGHAM
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35242-4654
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-995-5078
Provider Business Practice Location Address Fax Number:
205-995-5738
Provider Enumeration Date:
03/02/2007

Additional Information

Authorized Official

Authorized Official Last Name:
FRENCH
Authorized Official First Name:
JEFFERY
Authorized Official Middle Name:
T
Authorized Official Title or Position:
OWNER-DOCTOR OF CHIROPRACTIC
Authorized Official Telephone Number:
205-995-5078

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  2174 , 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: 515-38528FRE . This is a "BCBS" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".




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