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General NPI Number Information
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NPI Number | 1497818496
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Entity Type | Organization
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Legal Business Name | DR. PAULA GILLIAM CHIROPRACTIC CLINIC, INC.
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Dates
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Enumeration Date | 12/19/2006
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Last Update Date | 02/06/2012
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Provider Practice Location Address
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Address Line | 1900 SPARKMAN DR NW # A
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City | HUNTSVILLE
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State | AL
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Zip | 35816-1124
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Country | US
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Telephone | 256-430-0021
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Fax | 256-830-1364
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Provider Business Mailing Address
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Address Line | 1900 SPARKMAN DR NW #A
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City | HUNTSVILLE
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State | AL
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Zip | 35816
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Country | US
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Telephone | 256-430-0021
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Fax | 256-830-1364
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PAULA DEAN GILLIAM
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Credential | D.C.
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Telephone | 256-430-0021
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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 | 0961
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License Number State | AL
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