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General NPI Number Information
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NPI Number | 1356495378
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Entity Type | Organization
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Legal Business Name | WEST MOBILE CHIROPRACTIC P.C.
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 03/12/2008
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Provider Practice Location Address
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Address Line | 260 CODY RD S
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City | MOBILE
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State | AL
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Zip | 36695-3408
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Country | US
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Telephone | 251-344-8588
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Fax | 251-344-8985
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Provider Business Mailing Address
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Address Line | 260 CODY RD S
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City | MOBILE
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State | AL
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Zip | 36695-3408
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Country | US
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Telephone | 251-344-8588
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Fax | 251-344-8985
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN MATTHEW YOUNGBLOOD
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Credential | D.C.
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Telephone | 251-344-8588
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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 | 1101
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License Number State | AL
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