Provider Demographics
NPI:1740662816
Name:GADSDEN FAMILY CHIROPRACTIC
Entity type:Organization
Organization Name:GADSDEN FAMILY CHIROPRACTIC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:TORTORIELLO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:256-543-3033
Mailing Address - Street 1:211 SOUTH 5TH ST
Mailing Address - Street 2:D
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35901
Mailing Address - Country:US
Mailing Address - Phone:256-543-3033
Mailing Address - Fax:256-543-3373
Practice Address - Street 1:211 S 5TH ST
Practice Address - Street 2:D
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35901-4217
Practice Address - Country:US
Practice Address - Phone:256-543-3033
Practice Address - Fax:256-543-3373
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-24
Last Update Date:2015-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2035111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
051514046Medicare PIN