Provider Demographics
NPI:1437454337
Name:LEEDS FAMILY CHIROPRACTIC INC
Entity Type:Organization
Organization Name:LEEDS FAMILY CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL PARTNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JILL
Authorized Official - Middle Name:K
Authorized Official - Last Name:PALMA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:205-699-6600
Mailing Address - Street 1:1101 HIGROVE PKWY
Mailing Address - Street 2:SUITE 113
Mailing Address - City:LEEDS
Mailing Address - State:AL
Mailing Address - Zip Code:35094-1700
Mailing Address - Country:US
Mailing Address - Phone:205-699-6600
Mailing Address - Fax:866-398-9574
Practice Address - Street 1:1101 HIGROVE PKWY
Practice Address - Street 2:SUITE 113
Practice Address - City:LEEDS
Practice Address - State:AL
Practice Address - Zip Code:35094-1700
Practice Address - Country:US
Practice Address - Phone:205-699-6600
Practice Address - Fax:866-398-9574
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-24
Last Update Date:2011-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2324111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL2324OtherALABAMA STATE BOARD OF CHIROPRACTIC EXAMINERS LICENSE NUMBER