Healthcare Provider Details
I. General information
NPI: 1881889921
Provider Name (Legal Business Name): MEGHAN JOHN CORPORATION THE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/12/2007
Last Update Date: 09/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1190 MAIN STREET
SUMITON AL
35148
US
IV. Provider business mailing address
PO BOX 656
SUMITON AL
35148-0656
US
V. Phone/Fax
- Phone: 205-648-2660
- Fax: 205-648-2886
- Phone: 205-648-2660
- Fax: 205-648-2886
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111NN0400X |
| Taxonomy | Neurology Chiropractor |
| License Number | 1563/265AL |
| License Number State | AL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QH0100X |
| Taxonomy | Health Service Clinic/Center |
| License Number | 1563/265AL |
| License Number State | AL |
VIII. Authorized Official
Name: DR.
JOHN
DOUGLAS
BROWN
Title or Position: PRESIDENT
Credential: D.C.
Phone: 205-648-2660