Provider Demographics
NPI:1457428799
Name:DODD CHIROPRACTIC
Entity Type:Organization
Organization Name:DODD CHIROPRACTIC
Other - Org Name:TUGGLE CHIROPRACTIC CLINIC P.A.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LEAH
Authorized Official - Middle Name:J
Authorized Official - Last Name:SHIPP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-734-7315
Mailing Address - Street 1:525 MAIN AVE SW
Mailing Address - Street 2:
Mailing Address - City:CULLMAN
Mailing Address - State:AL
Mailing Address - Zip Code:35055-4700
Mailing Address - Country:US
Mailing Address - Phone:256-734-7315
Mailing Address - Fax:256-739-4390
Practice Address - Street 1:525 MAIN AVE SW
Practice Address - Street 2:
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35055-4700
Practice Address - Country:US
Practice Address - Phone:256-734-7315
Practice Address - Fax:256-739-4390
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
Last Update Date:2011-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL9467111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051070021OtherPROVIDER NUMBER
AL051506982OtherPROVIDER NUMBER
AL1639262355OtherNPI
AL1366536310OtherNPI
ALT68602Medicare UPIN
AL1639262355OtherNPI