Provider Demographics
NPI:1942567805
Name:BISHOP CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:BISHOP CHIROPRACTIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TIM
Authorized Official - Middle Name:R
Authorized Official - Last Name:BISHOP
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:256-332-0420
Mailing Address - Street 1:501 SAINT CLAIR ST SE
Mailing Address - Street 2:
Mailing Address - City:RUSSELLVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35653-2719
Mailing Address - Country:US
Mailing Address - Phone:256-332-0420
Mailing Address - Fax:256-332-1577
Practice Address - Street 1:501 SAINT CLAIR ST SE
Practice Address - Street 2:
Practice Address - City:RUSSELLVILLE
Practice Address - State:AL
Practice Address - Zip Code:35653-2719
Practice Address - Country:US
Practice Address - Phone:256-332-0420
Practice Address - Fax:256-332-1577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-17
Last Update Date:2012-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1106111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty