Provider Demographics
NPI:1427301951
Name:HANCOCK CHIROPRACTIC LLC
Entity type:Organization
Organization Name:HANCOCK CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:HANCOCK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:256-504-9205
Mailing Address - Street 1:1000 FORREST PL
Mailing Address - Street 2:SUITE 4
Mailing Address - City:PELL CITY
Mailing Address - State:AL
Mailing Address - Zip Code:35128-2308
Mailing Address - Country:US
Mailing Address - Phone:205-814-1118
Mailing Address - Fax:205-814-1119
Practice Address - Street 1:1000 FORREST PL
Practice Address - Street 2:SUITE 4
Practice Address - City:PELL CITY
Practice Address - State:AL
Practice Address - Zip Code:35128-2308
Practice Address - Country:US
Practice Address - Phone:205-814-1118
Practice Address - Fax:205-814-1119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-22
Last Update Date:2012-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2175111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty