Healthcare Provider Details

I. General information

NPI: 1174783153
Provider Name (Legal Business Name): DUFF CHIROPRACTIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2008
Last Update Date: 06/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20531 WEST BLVD
SILVERHILL AL
36576
US

IV. Provider business mailing address

20531 WEST BLVD
SILVERHILL AL
36576
US

V. Phone/Fax

Practice location:
  • Phone: 251-945-3034
  • Fax: 251-945-3034
Mailing address:
  • Phone: 251-945-3034
  • Fax: 251-945-3034

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2110
License Number StateAL

VIII. Authorized Official

Name: DR. LEONARD ASHWORTH DUFF
Title or Position: REGISTERED AGENT MANAGER
Credential: DC
Phone: 251-945-3034