Healthcare Provider Details

I. General information

NPI: 1306104039
Provider Name (Legal Business Name): PRECISION CHIROPRACTIC AND REHABILITATION, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2012
Last Update Date: 05/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 OWENS PKWY SUITE A
BIRMINGHAM AL
35244-1657
US

IV. Provider business mailing address

104 OWENS PKWY SUITE A
BIRMINGHAM AL
35244-1657
US

V. Phone/Fax

Practice location:
  • Phone: 205-988-9848
  • Fax:
Mailing address:
  • Phone: 205-988-9848
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number2366
License Number StateAL

VIII. Authorized Official

Name: DR. MARTY C LOVVORN
Title or Position: OWNER
Credential: D.C.
Phone: 205-988-9848