Provider Demographics
NPI:1063723419
Name:CHIROMED SPINE & REHAB CENTER INC.
Entity type:Organization
Organization Name:CHIROMED SPINE & REHAB CENTER INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TRAVIS
Authorized Official - Middle Name:ALLAN
Authorized Official - Last Name:LOWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:256-353-4605
Mailing Address - Street 1:2691 SANDLIN RD SW
Mailing Address - Street 2:SUITE A
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601-7361
Mailing Address - Country:US
Mailing Address - Phone:256-353-4600
Mailing Address - Fax:256-353-2352
Practice Address - Street 1:2691 SANDLIN RD SW
Practice Address - Street 2:SUITE A
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-7361
Practice Address - Country:US
Practice Address - Phone:256-353-4600
Practice Address - Fax:256-353-2352
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-30
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1343111N00000X
208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty