Healthcare Provider Details

I. General information

NPI: 1396650347
Provider Name (Legal Business Name): HALEY NICHOLE GODFREY DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2026
Last Update Date: 08/15/2026
Certification Date: 08/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5610 FLETCHER RD
MC CALLA AL
35111-3252
US

IV. Provider business mailing address

5610 FLETCHER RD
MC CALLA AL
35111-3252
US

V. Phone/Fax

Practice location:
  • Phone: 816-550-6372
  • Fax:
Mailing address:
  • Phone: 816-550-6372
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2934
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: