Provider Demographics
NPI:1417220328
Name:VALLEYDALE CHIROPRACTIC, P.C.
Entity Type:Organization
Organization Name:VALLEYDALE CHIROPRACTIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHERER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:205-987-7900
Mailing Address - Street 1:2080 VALLEYDALE RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35244-2091
Mailing Address - Country:US
Mailing Address - Phone:205-987-7900
Mailing Address - Fax:205-987-7684
Practice Address - Street 1:2080 VALLEYDALE RD
Practice Address - Street 2:SUITE 1
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35244-2091
Practice Address - Country:US
Practice Address - Phone:205-987-7900
Practice Address - Fax:205-987-7684
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-23
Last Update Date:2012-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1645111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
000036920Medicare UPIN