MEDICARE: CONNECTED CHIROPRACTIC HEALTH AND WELLNESS CENTER LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1285461038
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CONNECTED CHIROPRACTIC HEALTH AND WELLNESS CENTER LLC

Provider Business Mailing Address
First Line	:	7734 MADISON BLVD STE 103
Second Line	:
City	:	HUNTSVILLE
State	:	AL
Zip	:	35806-2379
Country	:	US
Telephone Number	:	256-469-5814
Fax Number	:

Provider Business Practice Location Address
First Line	:	7734 MADISON BLVD STE 103
Second Line	:
City	:	HUNTSVILLE
State	:	AL
Zip	:	35806-2379
Country	:	US
Telephone Number	:	256-469-5814
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. TERESA PAIGE ECHOLS
Credential	:	DC
Telephone Number	:	256-469-5814

Provider Enumeration Date	:	09/16/2024
Last Update Date	:	09/17/2024

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