Provider Demographics
NPI:1629160429
Name:ALLEN, DARRYL WAYNE (DC)
Entity Type:Individual
Prefix:DR
First Name:DARRYL
Middle Name:WAYNE
Last Name:ALLEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 W LAUREL AVE
Mailing Address - Street 2:
Mailing Address - City:FOLEY
Mailing Address - State:AL
Mailing Address - Zip Code:36535-1919
Mailing Address - Country:US
Mailing Address - Phone:251-943-9430
Mailing Address - Fax:251-943-9888
Practice Address - Street 1:224 W LAUREL AVE
Practice Address - Street 2:
Practice Address - City:FOLEY
Practice Address - State:AL
Practice Address - Zip Code:36535-1919
Practice Address - Country:US
Practice Address - Phone:251-943-9430
Practice Address - Fax:251-943-9888
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1564111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALU52624Medicare UPIN
AL051550356ALLMedicare ID - Type UnspecifiedMEDICARE