Provider Demographics
NPI:1821419318
Name:PROTZ CHIROPRACTIC WELLNESS CLINIC, LLC
Entity Type:Organization
Organization Name:PROTZ CHIROPRACTIC WELLNESS CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:PROTZ
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:256-593-3551
Mailing Address - Street 1:12815 US HIGHWAY 431
Mailing Address - Street 2:
Mailing Address - City:SARDIS CITY
Mailing Address - State:AL
Mailing Address - Zip Code:35956-2046
Mailing Address - Country:US
Mailing Address - Phone:256-593-3551
Mailing Address - Fax:256-593-4603
Practice Address - Street 1:12815 US HIGHWAY 431
Practice Address - Street 2:
Practice Address - City:SARDIS CITY
Practice Address - State:AL
Practice Address - Zip Code:35956-2046
Practice Address - Country:US
Practice Address - Phone:256-593-3551
Practice Address - Fax:256-593-4603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-30
Last Update Date:2013-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1632111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty