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General NPI Number Information
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NPI Number | 1023745882
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Entity Type | Organization
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Legal Business Name | BOAZ CHIROPRACTIC
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Dates
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Enumeration Date | 08/02/2022
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Last Update Date | 03/29/2024
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Provider Practice Location Address
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Address Line | 419 US HIGHWAY 431
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City | BOAZ
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State | AL
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Zip | 35957-2183
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Country | US
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Telephone | 256-840-5558
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Fax | 256-298-5085
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Provider Business Mailing Address
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Address Line | 419 US HIGHWAY 431
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City | BOAZ
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State | AL
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Zip | 35957-2183
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Country | US
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Telephone | 256-840-5558
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Fax | 256-298-5085
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Authorized Official
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Title or Position | PRESIDENT/CHIROPRACTOR
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Name | MARTHA T HATALA
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Credential | D.C.
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Telephone | 256-840-5558
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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