Provider Demographics
NPI:1992032320
Name:ADIO CHIROPRACTIC
Entity Type:Organization
Organization Name:ADIO CHIROPRACTIC
Other - Org Name:BACK ON TRACK CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISTOFFER
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:205-322-9005
Mailing Address - Street 1:1901 6TH AVE N
Mailing Address - Street 2:SUITE 260
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35203-2618
Mailing Address - Country:US
Mailing Address - Phone:205-322-9005
Mailing Address - Fax:205-322-9039
Practice Address - Street 1:1901 6TH AVE N
Practice Address - Street 2:SUITE 260
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35203-2618
Practice Address - Country:US
Practice Address - Phone:205-322-9005
Practice Address - Fax:205-322-9039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-05
Last Update Date:2009-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1895111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALU77470Medicare UPIN