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General NPI Number Information
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NPI Number | 1689814543
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Entity Type | Organization
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Legal Business Name | HOMETOWN CHIROPRACTIC, LLC
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Dates
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Enumeration Date | 03/04/2009
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Last Update Date | 07/24/2015
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Provider Practice Location Address
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Address Line | 204 E COLLEGE ST
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City | COLUMBIANA
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State | AL
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Zip | 35051-9380
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Country | US
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Telephone | 205-225-1381
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 215
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City | COLUMBIANA
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State | AL
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Zip | 35051-0215
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Country | US
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Telephone | 205-225-1381
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. DAVID A STULL
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Credential | D.C
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Telephone | 205-225-1381
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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 | 2408
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License Number State | AL
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