Healthcare Provider Details
I. General information
NPI: 1023991031
Provider Name (Legal Business Name): GROOMS INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/28/2025
Last Update Date: 07/28/2025
Certification Date: 07/28/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
147 WESTCHESTER DR UNIT E
MADISON AL
35758-7112
US
IV. Provider business mailing address
147 WESTCHESTER DR UNIT E
MADISON AL
35758-7112
US
V. Phone/Fax
- Phone: 256-777-2679
- Fax:
- Phone: 256-777-2679
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111NS0005X |
| Taxonomy | Sports Physician Chiropractor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
STEPHEN
GROOMS
Title or Position: PRESIDENT
Credential: DC
Phone: 334-354-7550