Provider Demographics
NPI:1831305937
Name:INNATE CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:INNATE CHIROPRACTIC, INC.
Other - Org Name:LAKE CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LAKE
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANKLIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:205-394-2340
Mailing Address - Street 1:305 HEATH DR
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-4028
Mailing Address - Country:US
Mailing Address - Phone:205-380-0574
Mailing Address - Fax:205-968-5854
Practice Address - Street 1:3017 PUMP HOUSE RD
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35243-1847
Practice Address - Country:US
Practice Address - Phone:205-380-0574
Practice Address - Fax:205-968-5854
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2181111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51539961OtherBCBS