1811173248 NPI number — CHIROPARTNERS INC

Table of content: (NPI 1811173248)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811173248 NPI number — CHIROPARTNERS INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHIROPARTNERS 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:
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:
1811173248
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/25/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
21040 MIFLIN RD
Provider Second Line Business Mailing Address:
SUITE 6
Provider Business Mailing Address City Name:
FOLEY
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
36535-9296
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
251-955-2225
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
21040 MIFLIN RD
Provider Second Line Business Practice Location Address:
SUITE 6
Provider Business Practice Location Address City Name:
FOLEY
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
36535-9296
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
251-955-2225
Provider Business Practice Location Address Fax Number:
251-970-2225
Provider Enumeration Date:
01/16/2008

Additional Information

Authorized Official

Authorized Official Last Name:
RIZZUTO
Authorized Official First Name:
RICHARD
Authorized Official Middle Name:
W
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
251-955-2225

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 515-38744 . This is a "BLUE CROSS BLUE SHEILD" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 4606539 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".




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