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General NPI Number Information
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NPI Number | 1306104039
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Entity Type | Organization
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Legal Business Name | PRECISION CHIROPRACTIC AND REHABILITATION, PC
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Dates
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Enumeration Date | 05/01/2012
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Last Update Date | 05/01/2012
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Provider Practice Location Address
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Address Line | 104 OWENS PKWY SUITE A
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City | BIRMINGHAM
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State | AL
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Zip | 35244-1657
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Country | US
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Telephone | 205-988-9848
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Fax |
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Provider Business Mailing Address
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Address Line | 104 OWENS PKWY SUITE A
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City | BIRMINGHAM
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State | AL
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Zip | 35244-1657
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Country | US
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Telephone | 205-988-9848
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARTY C LOVVORN
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Credential | D.C.
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Telephone | 205-988-9848
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | 2366
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License Number State | AL
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