Provider Demographics
NPI:1730285461
Name:CHIROPRACTIC WORKS, PC
Entity Type:Organization
Organization Name:CHIROPRACTIC WORKS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BE
Authorized Official - Middle Name:
Authorized Official - Last Name:PHETSINORATH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:251-665-4999
Mailing Address - Street 1:3263 DEMETROPOLIS RD
Mailing Address - Street 2:SUITE 10
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36693-4638
Mailing Address - Country:US
Mailing Address - Phone:251-665-4999
Mailing Address - Fax:251-665-4998
Practice Address - Street 1:3263 DEMETROPOLIS RD
Practice Address - Street 2:SUITE 10
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36693-4638
Practice Address - Country:US
Practice Address - Phone:251-665-4999
Practice Address - Fax:251-665-4998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL074405111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
=========OtherTAX ID NUMBER