Provider Demographics
NPI:1194240739
Name:FAIRHOPE HEALTH & WELLNESS CENTER
Entity type:Organization
Organization Name:FAIRHOPE HEALTH & WELLNESS CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:KERR PATRICK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:251-990-8188
Mailing Address - Street 1:909B PLANTATION BLVD
Mailing Address - Street 2:
Mailing Address - City:FAIRHOPE
Mailing Address - State:AL
Mailing Address - Zip Code:36532-2949
Mailing Address - Country:US
Mailing Address - Phone:251-990-8188
Mailing Address - Fax:
Practice Address - Street 1:909B PLANTATION BLVD
Practice Address - Street 2:
Practice Address - City:FAIRHOPE
Practice Address - State:AL
Practice Address - Zip Code:36532-2949
Practice Address - Country:US
Practice Address - Phone:251-990-8188
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2250111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty