Healthcare Provider Details

I. General information

NPI: 1750436325
Provider Name (Legal Business Name): PAUL ANDREW PROTZ JR. D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 10/25/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12815 US HIGHWAY 431
SARDIS CITY AL
35956-2046
US

IV. Provider business mailing address

4282 BRASHIERS CHAPEL RD
ARAB AL
35016-3418
US

V. Phone/Fax

Practice location:
  • Phone: 256-593-3551
  • Fax: 256-593-4603
Mailing address:
  • Phone: 256-738-3388
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1632
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: