Provider Demographics
NPI:1295930741
Name:FAMILY WELLNESS CHIROPRACTIC LLC
Entity type:Organization
Organization Name:FAMILY WELLNESS CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:R
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC, CACCP
Authorized Official - Phone:205-492-3015
Mailing Address - Street 1:4500 VALLEYDALE RD
Mailing Address - Street 2:SUITE 1000
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-4636
Mailing Address - Country:US
Mailing Address - Phone:205-991-7374
Mailing Address - Fax:205-991-7109
Practice Address - Street 1:2481 VALLEYDALE ROAD
Practice Address - Street 2:SUITE A
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35244
Practice Address - Country:US
Practice Address - Phone:205-991-7374
Practice Address - Fax:205-991-7109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-15
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1318111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000072565Medicare ID - Type Unspecified