Provider Demographics
NPI:1003901380
Name:SILVER GROUP CHIROPRACTIC, INC
Entity Type:Organization
Organization Name:SILVER GROUP CHIROPRACTIC, INC
Other - Org Name:HEALTH STAR CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:P
Authorized Official - Last Name:SILVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-356-1111
Mailing Address - Street 1:PO BOX 241467
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36124-1467
Mailing Address - Country:US
Mailing Address - Phone:334-356-1111
Mailing Address - Fax:334-356-9873
Practice Address - Street 1:3283 MALCOLM DR
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36116-8816
Practice Address - Country:US
Practice Address - Phone:334-356-1111
Practice Address - Fax:334-356-9873
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2011-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALA0009111N00000X
207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51516135OtherBCBSAL
AL51536447OtherBCBS
AL51532805OtherBCBSAL
AL51525026OtherBCBSAL
AL51536447OtherBCBS