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General NPI Number Information
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NPI Number | 1851149033
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Entity Type | Organization
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Legal Business Name | DRCRAIGMIX LLC
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Dates
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Enumeration Date | 05/11/2024
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Last Update Date | 06/13/2025
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Provider Practice Location Address
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Address Line | 1013 W FORT WILLIAMS ST
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City | SYLACAUGA
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State | AL
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Zip | 35150-2301
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Country | US
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Telephone | 256-245-2258
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Fax | 205-235-2335
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Provider Business Mailing Address
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Address Line | 1034 NORMAN DR
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City | VESTAVIA
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State | AL
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Zip | 35242-6605
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Country | US
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Telephone | 205-352-6721
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Fax |
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Authorized Official
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Title or Position | OWNER/CHIROPRACTOR
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Name | CRAIG A MIX
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Credential | DC
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Telephone | 205-734-1344
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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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