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General NPI Number Information
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NPI Number | 1821605700
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Entity Type | Organization
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Legal Business Name | MOTIVITY CHIROPRACTIC
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Dates
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Enumeration Date | 09/25/2020
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Last Update Date | 09/25/2020
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Provider Practice Location Address
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Address Line | 2413 2ND AVENUE SOUTH STE 100
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City | BIRMINGHAM
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State | AL
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Zip | 35233
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Country | US
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Telephone | 205-356-7204
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Fax |
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Provider Business Mailing Address
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Address Line | 525 HICKORY ST
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City | BIRMINGHAM
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State | AL
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Zip | 35206-3024
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Country | US
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Telephone | 205-910-1430
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | RAYMOND KNORR
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Credential | DC
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Telephone | 205-910-1430
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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 |
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License Number State |
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