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General NPI Number Information
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NPI Number | 1568016004
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Entity Type | Organization
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Legal Business Name | FENTON CHIROPRACTIC LLC
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Dates
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Enumeration Date | 08/01/2019
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Last Update Date | 08/01/2019
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Provider Practice Location Address
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Address Line | 301 1ST ST S
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City | REFORM
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State | AL
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Zip | 35481-8013
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Country | US
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Telephone | 205-375-2959
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Fax | 205-469-8014
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Provider Business Mailing Address
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Address Line | PO BOX 340
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City | REFORM
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State | AL
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Zip | 35481-0340
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Country | US
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Telephone | 205-375-2959
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Fax | 205-469-8014
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Authorized Official
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Title or Position | OWNER
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Name | DR. JAMES FENTON
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Credential | DC
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Telephone | 205-375-2959
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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