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General NPI Number Information
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NPI Number | 1427301951
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Entity Type | Organization
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Legal Business Name | HANCOCK CHIROPRACTIC LLC
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Dates
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Enumeration Date | 10/22/2012
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Last Update Date | 10/22/2012
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Provider Practice Location Address
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Address Line | 1000 FORREST PL SUITE 4
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City | PELL CITY
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State | AL
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Zip | 35128-2308
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Country | US
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Telephone | 205-814-1118
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Fax | 205-814-1119
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Provider Business Mailing Address
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Address Line | 1000 FORREST PL SUITE 4
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City | PELL CITY
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State | AL
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Zip | 35128-2308
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Country | US
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Telephone | 205-814-1118
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Fax | 205-814-1119
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Authorized Official
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Title or Position | OWNER
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Name | DR. GARY DANIEL HANCOCK
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Credential | D.C
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Telephone | 256-504-9205
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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 | 2175
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License Number State | AL
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