Provider Demographics
NPI:1801648928
Name:PILLAR TRUSSVILLE LLC
Entity type:Organization
Organization Name:PILLAR TRUSSVILLE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:
Authorized Official - Last Name:RUSSELL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:205-515-7193
Mailing Address - Street 1:3153 CAHABA HEIGHTS RD
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA
Mailing Address - State:AL
Mailing Address - Zip Code:35243-5246
Mailing Address - Country:US
Mailing Address - Phone:205-537-7463
Mailing Address - Fax:205-967-0408
Practice Address - Street 1:7101 HAPPY HOLLOW RD
Practice Address - Street 2:
Practice Address - City:TRUSSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35173-2544
Practice Address - Country:US
Practice Address - Phone:205-537-7463
Practice Address - Fax:205-967-0408
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-02
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty