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General NPI Number Information
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NPI Number | 1619095312
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Entity Type | Organization
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Legal Business Name | CHIROCARE OF ATHENS
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Dates
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Enumeration Date | 03/27/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 27453 CAPSHAW RD STE B
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City | ATHENS
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State | AL
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Zip | 35613-7511
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Country | US
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Telephone | 256-216-1006
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Fax |
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Provider Business Mailing Address
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Address Line | 27453 CAPSHAW RD STE B
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City | ATHENS
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State | AL
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Zip | 35613-7511
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MICHAEL HEDGEPETH
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Credential |
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Telephone | 256-216-1006
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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 | 2073
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2075
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License Number State | AL
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