Provider Demographics
NPI:1063740892
Name:E Z HEALTH CLINIC
Entity type:Organization
Organization Name:E Z HEALTH CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:PAK
Authorized Official - Suffix:
Authorized Official - Credentials:DC,LAC
Authorized Official - Phone:334-270-0284
Mailing Address - Street 1:3845 INTERSTATE CT STE 5
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36109-5223
Mailing Address - Country:US
Mailing Address - Phone:334-270-0284
Mailing Address - Fax:
Practice Address - Street 1:3845 INTERSTATE CT STE 5
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36109-5223
Practice Address - Country:US
Practice Address - Phone:334-270-0284
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-07
Last Update Date:2009-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty