Provider Demographics
NPI:1225000896
Name:POSSEHL ENTERPRISES INC
Entity Type:Organization
Organization Name:POSSEHL ENTERPRISES INC
Other - Org Name:SOUTH BALDWIN CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:R
Authorized Official - Last Name:POSSEHL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:251-943-7332
Mailing Address - Street 1:423 N MCKENZIE ST
Mailing Address - Street 2:
Mailing Address - City:FOLEY
Mailing Address - State:AL
Mailing Address - Zip Code:36535-3536
Mailing Address - Country:US
Mailing Address - Phone:251-943-7332
Mailing Address - Fax:
Practice Address - Street 1:423 N MCKENZIE ST
Practice Address - Street 2:
Practice Address - City:FOLEY
Practice Address - State:AL
Practice Address - Zip Code:36535-3536
Practice Address - Country:US
Practice Address - Phone:251-943-7332
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-07
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1390111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51007988OtherBCBS AL
O26365Medicare UPIN
000007988Medicare ID - Type Unspecified