Provider Demographics
NPI:1538506340
Name:KAISER, ELLICIA CLAIRE (DC)
Entity Type:Individual
Prefix:DR
First Name:ELLICIA
Middle Name:CLAIRE
Last Name:KAISER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:ELLICIA
Other - Middle Name:CLAIRE
Other - Last Name:CARAWAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3153 CAHABA HEIGHTS RD
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA
Mailing Address - State:AL
Mailing Address - Zip Code:35243-5246
Mailing Address - Country:US
Mailing Address - Phone:205-967-0280
Mailing Address - Fax:205-967-0408
Practice Address - Street 1:3153 CAHABA HEIGHTS RD
Practice Address - Street 2:
Practice Address - City:VESTAVIA
Practice Address - State:AL
Practice Address - Zip Code:35243-5246
Practice Address - Country:US
Practice Address - Phone:205-967-0280
Practice Address - Fax:205-967-0408
Is Sole Proprietor?:No
Enumeration Date:2013-06-03
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4191111N00000X
AL2774111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor