Healthcare Provider Details

I. General information

NPI: 1295564532
Provider Name (Legal Business Name): EARLY BIRD CHIROPRACTIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2024
Last Update Date: 09/13/2024
Certification Date: 09/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 BROOKLYN RD
HOLLY POND AL
35083-6487
US

IV. Provider business mailing address

715 COUNTY ROAD 783
CULLMAN AL
35055-8017
US

V. Phone/Fax

Practice location:
  • Phone: 256-747-5227
  • Fax:
Mailing address:
  • Phone: 256-531-3485
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. HALEY BEASLEY
Title or Position: CHIROPRACTOR
Credential: D.C.
Phone: 256-531-3485