Provider Demographics
NPI:1457545329
Name:ASSOCIATED CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:ASSOCIATED CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:SHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:JEFFREYS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-974-7778
Mailing Address - Street 1:940 EAST ST
Mailing Address - Street 2:
Mailing Address - City:MOULTON
Mailing Address - State:AL
Mailing Address - Zip Code:35650-1212
Mailing Address - Country:US
Mailing Address - Phone:256-974-7778
Mailing Address - Fax:256-974-7792
Practice Address - Street 1:940 EAST ST
Practice Address - Street 2:
Practice Address - City:MOULTON
Practice Address - State:AL
Practice Address - Zip Code:35650-1212
Practice Address - Country:US
Practice Address - Phone:256-974-7778
Practice Address - Fax:256-974-7792
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-04
Last Update Date:2007-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL730111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty