Provider Demographics
NPI:1750767075
Name:FAMILY TREE CHIROPRACTIC LLC
Entity type:Organization
Organization Name:FAMILY TREE CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:ALIMENT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:425-442-9018
Mailing Address - Street 1:8158 STATE HIGHWAY 59
Mailing Address - Street 2:SUITE 106
Mailing Address - City:FOLEY
Mailing Address - State:AL
Mailing Address - Zip Code:36535-3880
Mailing Address - Country:US
Mailing Address - Phone:251-943-0569
Mailing Address - Fax:251-943-0559
Practice Address - Street 1:8158 STATE HIGHWAY 59
Practice Address - Street 2:SUITE 106
Practice Address - City:FOLEY
Practice Address - State:AL
Practice Address - Zip Code:36535-3880
Practice Address - Country:US
Practice Address - Phone:251-943-0569
Practice Address - Fax:251-943-0559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-10
Last Update Date:2015-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2465111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty