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General NPI Number Information
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NPI Number | 1639606460
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Entity Type | Organization
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Legal Business Name | TUSCALOOSA CHIROPRACTIC, LLC
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Dates
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Enumeration Date | 05/11/2017
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Last Update Date | 05/11/2017
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Provider Practice Location Address
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Address Line | 2110 MCFARLAND BLVD E SUITE E
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City | TUSCALOOSA
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State | AL
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Zip | 35404-5857
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Country | US
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Telephone | 205-462-3384
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Fax | 205-722-2178
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Provider Business Mailing Address
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Address Line | 2110 MCFARLAND BLVD E SUITE E
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City | TUSCALOOSA
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State | AL
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Zip | 35404-5857
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Country | US
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Telephone | 205-462-3384
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Fax | 205-722-2178
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Authorized Official
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Title or Position | OWNER
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Name | DR. COREY ALEXANDER NEILL
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Credential | D.C.
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Telephone | 762-359-6100
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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 | 2534
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License Number State | AL
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