Provider Demographics
NPI:1013780030
Name:HS OF MUSCLE SHOALS LLC
Entity type:Organization
Organization Name:HS OF MUSCLE SHOALS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:TYLER
Authorized Official - Last Name:JUMPER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:256-994-9575
Mailing Address - Street 1:3312 WOODWARD AVE STE A101
Mailing Address - Street 2:
Mailing Address - City:MUSCLE SHOALS
Mailing Address - State:AL
Mailing Address - Zip Code:35661-3331
Mailing Address - Country:US
Mailing Address - Phone:256-994-9575
Mailing Address - Fax:256-484-8604
Practice Address - Street 1:3312 WOODWARD AVE STE A101
Practice Address - Street 2:
Practice Address - City:MUSCLE SHOALS
Practice Address - State:AL
Practice Address - Zip Code:35661-3331
Practice Address - Country:US
Practice Address - Phone:256-994-9575
Practice Address - Fax:256-484-8604
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-01
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty