Provider Demographics
NPI:1558543231
Name:EUFAULA FAMILY CHIROPRACTIC, P.C.
Entity Type:Organization
Organization Name:EUFAULA FAMILY CHIROPRACTIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:IAN
Authorized Official - Last Name:GILLIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:334-687-3855
Mailing Address - Street 1:129 S ORANGE AVE
Mailing Address - Street 2:
Mailing Address - City:EUFAULA
Mailing Address - State:AL
Mailing Address - Zip Code:36027-1626
Mailing Address - Country:US
Mailing Address - Phone:334-687-3855
Mailing Address - Fax:334-687-0622
Practice Address - Street 1:129 S ORANGE AVE
Practice Address - Street 2:
Practice Address - City:EUFAULA
Practice Address - State:AL
Practice Address - Zip Code:36027-1626
Practice Address - Country:US
Practice Address - Phone:334-687-3855
Practice Address - Fax:334-687-0622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-04
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2064111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALU97140Medicare UPIN