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General NPI Number Information
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NPI Number | 1225488083
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Entity Type | Organization
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Legal Business Name | PHILLIPS FAMILY CHIROPRACTIC LLC
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Dates
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Enumeration Date | 06/13/2016
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Last Update Date | 06/13/2016
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Provider Practice Location Address
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Address Line | 600 MAIN ST
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City | GARDENDALE
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State | AL
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Zip | 35071-4675
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Country | US
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Telephone | 205-631-8808
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Fax | 205-631-8832
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Provider Business Mailing Address
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Address Line | PO BOX 1043
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City | GARDENDALE
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State | AL
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Zip | 35071-4675
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Country | US
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Telephone | 205-631-8808
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Fax | 205-631-8832
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. GRAYSON PHILLIPS
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Credential | D.C.
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Telephone | 205-631-8808
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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 | 2489
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License Number State | AL
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