Provider Demographics
NPI:1093772626
Name:WEBER, ALAN J (DC)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:J
Last Name:WEBER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2301 MOODY PKWY
Mailing Address - Street 2:SUITE 5
Mailing Address - City:MOODY
Mailing Address - State:AL
Mailing Address - Zip Code:35004-3040
Mailing Address - Country:US
Mailing Address - Phone:205-640-8023
Mailing Address - Fax:205-640-4925
Practice Address - Street 1:2301 MOODY PKWY
Practice Address - Street 2:SUITE 5
Practice Address - City:MOODY
Practice Address - State:AL
Practice Address - Zip Code:35004-3040
Practice Address - Country:US
Practice Address - Phone:205-640-8023
Practice Address - Fax:205-640-4925
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-27
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ALP2151111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51070777Medicare ID - Type Unspecified
ALT68617Medicare UPIN