Provider Demographics
NPI:1740302314
Name:HOLLOWELL CHIROPRACTIC, INC
Entity type:Organization
Organization Name:HOLLOWELL CHIROPRACTIC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLLOWELL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:334-393-4425
Mailing Address - Street 1:557 GLOVER AVE
Mailing Address - Street 2:STE 27
Mailing Address - City:ENTERPRISE
Mailing Address - State:AL
Mailing Address - Zip Code:36330-2024
Mailing Address - Country:US
Mailing Address - Phone:334-393-4425
Mailing Address - Fax:334-347-7074
Practice Address - Street 1:557 GLOVER AVE
Practice Address - Street 2:STE 27
Practice Address - City:ENTERPRISE
Practice Address - State:AL
Practice Address - Zip Code:36330-2024
Practice Address - Country:US
Practice Address - Phone:334-393-4425
Practice Address - Fax:334-347-7074
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1335111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL72906Medicare ID - Type Unspecified
ALU13226Medicare UPIN