Provider Demographics
NPI:1942505797
Name:THE CLINIC PROFESSIONAL HANDS ON CENTER LLC
Entity Type:Organization
Organization Name:THE CLINIC PROFESSIONAL HANDS ON CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LABARRON
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKINNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-709-6076
Mailing Address - Street 1:317 MORGAN AVE
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36606-1738
Mailing Address - Country:US
Mailing Address - Phone:251-470-8758
Mailing Address - Fax:251-470-8758
Practice Address - Street 1:317 MORGAN AVE
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36606-1738
Practice Address - Country:US
Practice Address - Phone:251-470-8758
Practice Address - Fax:251-470-8758
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-25
Last Update Date:2011-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty