Provider Demographics
NPI:1952462954
Name:CONRAD, ALAN (DC)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:
Last Name:CONRAD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1206
Mailing Address - Street 2:1817 ANDREWS AVE
Mailing Address - City:OZARK
Mailing Address - State:AL
Mailing Address - Zip Code:36361-1206
Mailing Address - Country:US
Mailing Address - Phone:334-774-7576
Mailing Address - Fax:334-774-7474
Practice Address - Street 1:1817 ANDREWS AVE
Practice Address - Street 2:
Practice Address - City:OZARK
Practice Address - State:AL
Practice Address - Zip Code:36360
Practice Address - Country:US
Practice Address - Phone:334-774-7576
Practice Address - Fax:334-774-7474
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1039111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor