Provider Demographics
NPI:1174671663
Name:ANDERSON CHIROPRACTIC CLINCI
Entity Type:Organization
Organization Name:ANDERSON CHIROPRACTIC CLINCI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOLENE
Authorized Official - Middle Name:BIRCH
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-764-5493
Mailing Address - Street 1:215 W COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35630-5568
Mailing Address - Country:US
Mailing Address - Phone:256-764-5493
Mailing Address - Fax:256-764-5406
Practice Address - Street 1:215 W COLLEGE ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630-5568
Practice Address - Country:US
Practice Address - Phone:256-764-5493
Practice Address - Fax:256-764-5406
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty