Healthcare Provider Details

I. General information

NPI: 1619236833
Provider Name (Legal Business Name): AMERICAN BACK INSTITUTE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2012
Last Update Date: 12/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 MCCLELLAN BLVD
ANNISTON AL
36201-2724
US

IV. Provider business mailing address

PO BOX 1794
ANNISTON AL
36202-1794
US

V. Phone/Fax

Practice location:
  • Phone: 256-237-9423
  • Fax: 256-406-0578
Mailing address:
  • Phone: 256-237-9423
  • Fax: 256-237-6007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NI0013X
TaxonomyIndependent Medical Examiner Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. DAVID E WADE
Title or Position: MEMBER
Credential: DC
Phone: 256-310-0855