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General NPI Number Information
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NPI Number | 1194996561
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Entity Type | Organization
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Legal Business Name | COLE CHIROPRACTIC CLINIC
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Dates
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Enumeration Date | 03/13/2008
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Last Update Date | 03/13/2008
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Provider Practice Location Address
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Address Line | 129 N MULBERRY AVE
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City | BUTLER
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State | AL
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Zip | 36904-2223
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Country | US
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Telephone | 205-459-2833
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Fax | 334-289-0560
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Provider Business Mailing Address
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Address Line | 129 N MULBERRY AVE
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City | BUTLER
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State | AL
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Zip | 36904-2223
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Country | US
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Telephone | 205-459-2833
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Fax | 334-289-0560
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Authorized Official
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Title or Position | OWNER
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Name | LYLE WAYDE COLE
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Credential | DC
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Telephone | 205-459-2833
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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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