Provider Demographics
NPI:1053463422
Name:HULSE, RUSSELL D (DC)
Entity Type:Individual
Prefix:DR
First Name:RUSSELL
Middle Name:D
Last Name:HULSE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:897 HIGHWAY 31 SW
Mailing Address - Street 2:
Mailing Address - City:HARTSELLE
Mailing Address - State:AL
Mailing Address - Zip Code:35640-2872
Mailing Address - Country:US
Mailing Address - Phone:256-751-0033
Mailing Address - Fax:256-751-0037
Practice Address - Street 1:897 HIGHWAY 31 SW
Practice Address - Street 2:
Practice Address - City:HARTSELLE
Practice Address - State:AL
Practice Address - Zip Code:35640-2872
Practice Address - Country:US
Practice Address - Phone:256-751-0033
Practice Address - Fax:256-751-0037
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2014-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1636111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALU57551Medicare UPIN
AL75298Medicare ID - Type Unspecified