Healthcare Provider Details

I. General information

NPI: 1154376978
Provider Name (Legal Business Name): HALL CHIROPRACTIC CLINIC, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

613 E HOBBS ST
ATHENS AL
35611-2150
US

IV. Provider business mailing address

PO BOX 786
ATHENS AL
35612-0786
US

V. Phone/Fax

Practice location:
  • Phone: 256-232-5703
  • Fax:
Mailing address:
  • Phone: 256-232-5703
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1263
License Number StateAL

VIII. Authorized Official

Name: DR. CHARLES RONALD HALL
Title or Position: DOCTOR OF CHIROPRACTIC
Credential: R.PH., D.C.
Phone: 256-232-5703