Healthcare Provider Details

I. General information

NPI: 1932431707
Provider Name (Legal Business Name): CHIROPRACTIC OUTREACH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2010
Last Update Date: 02/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7032 US HIGHWAY 431
ALBERTVILLE AL
35950-1870
US

IV. Provider business mailing address

7032 US HIGHWAY 431
ALBERTVILLE AL
35950-1870
US

V. Phone/Fax

Practice location:
  • Phone: 256-878-1432
  • Fax: 256-878-1586
Mailing address:
  • Phone: 256-878-1432
  • Fax: 256-878-1586

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1297
License Number StateAL

VIII. Authorized Official

Name: DR. CYNTHIA M CAUGHMAN
Title or Position: PRESIDENT
Credential: DC
Phone: 256-878-1432