Provider Demographics
NPI:1811398548
Name:CHOICE CHIROPRACTIC, PC
Entity Type:Organization
Organization Name:CHOICE CHIROPRACTIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:E
Authorized Official - Last Name:SARGEANT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:256-509-6091
Mailing Address - Street 1:5575 HIGHWAY 431 S
Mailing Address - Street 2:SUITE 104
Mailing Address - City:BROWNSBORO
Mailing Address - State:AL
Mailing Address - Zip Code:35741-9748
Mailing Address - Country:US
Mailing Address - Phone:256-270-8059
Mailing Address - Fax:256-715-1853
Practice Address - Street 1:5575 HIGHWAY 431 S
Practice Address - Street 2:SUITE 104
Practice Address - City:BROWNSBORO
Practice Address - State:AL
Practice Address - Zip Code:35741-9748
Practice Address - Country:US
Practice Address - Phone:256-270-8059
Practice Address - Fax:256-715-1853
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-12
Last Update Date:2014-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALAL1792111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051518251OtherBC/BS OF ALABAMA AND MEDICARE PROVIDER NUMBER
1285741371OtherINDIVIDUAL NPI
1285741371OtherINDIVIDUAL NPI