Provider Demographics
NPI:1013399765
Name:UNIVERSITY CHIROPRACTIC
Entity Type:Organization
Organization Name:UNIVERSITY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:HITCHNER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:205-534-1873
Mailing Address - Street 1:523 QUEEN CITY AVE
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35401-1513
Mailing Address - Country:US
Mailing Address - Phone:205-248-7656
Mailing Address - Fax:205-248-7768
Practice Address - Street 1:523 QUEEN CITY AVE
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35401-1513
Practice Address - Country:US
Practice Address - Phone:205-248-7656
Practice Address - Fax:205-248-7768
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-18
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1341111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty