Provider Demographics
NPI:1639606460
Name:TUSCALOOSA CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:TUSCALOOSA CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:COREY
Authorized Official - Middle Name:ALEXANDER
Authorized Official - Last Name:NEILL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:762-359-6100
Mailing Address - Street 1:2110 MCFARLAND BLVD E
Mailing Address - Street 2:SUITE E
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35404-5857
Mailing Address - Country:US
Mailing Address - Phone:205-462-3384
Mailing Address - Fax:205-722-2178
Practice Address - Street 1:2110 MCFARLAND BLVD E
Practice Address - Street 2:SUITE E
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35404-5857
Practice Address - Country:US
Practice Address - Phone:205-462-3384
Practice Address - Fax:205-722-2178
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2534111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty