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General NPI Number Information
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NPI Number | 1871749994
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Entity Type | Organization
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Legal Business Name | SPINAL CARE AND WELLNESS CLINIC, INC
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Dates
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Enumeration Date | 08/08/2008
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Last Update Date | 08/08/2008
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Provider Practice Location Address
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Address Line | 2335 US HIGHWAY 43
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City | WINFIELD
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State | AL
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Zip | 35594-5166
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Country | US
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Telephone | 205-487-8865
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Fax | 205-487-2371
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Provider Business Mailing Address
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Address Line | 2335 US HIGHWAY 43
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City | WINFIELD
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State | AL
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Zip | 35594-5166
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Country | US
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Telephone | 205-487-8865
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Fax | 205-487-2371
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Authorized Official
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Title or Position | CEO/CLINIC DIRECTOR
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Name | DR. CHRISTOPHER TODD FETTER
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Credential | DC
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Telephone | 205-487-8865
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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 | 1812
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License Number State | AL
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