Provider Demographics
NPI:1487016036
Name:WITT CHIROPRACTIC,LLC
Entity Type:Organization
Organization Name:WITT CHIROPRACTIC,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:ELLEN
Authorized Official - Last Name:WITT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:205-871-1888
Mailing Address - Street 1:1919 COURTNEY DR
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-4101
Mailing Address - Country:US
Mailing Address - Phone:205-871-1888
Mailing Address - Fax:205-871-1899
Practice Address - Street 1:1919 COURTNEY DR
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-4101
Practice Address - Country:US
Practice Address - Phone:205-871-1888
Practice Address - Fax:205-871-1899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-23
Last Update Date:2016-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALU69592Medicare UPIN