Provider Demographics
NPI:1427635226
Name:RUNKEL CHIROPRACTIC LLC
Entity type:Organization
Organization Name:RUNKEL CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:RUNKEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:334-712-9177
Mailing Address - Street 1:1000 FOREST DR
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36303-3024
Mailing Address - Country:US
Mailing Address - Phone:334-712-9177
Mailing Address - Fax:
Practice Address - Street 1:1000 FOREST DR
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36303-3024
Practice Address - Country:US
Practice Address - Phone:334-712-9177
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-26
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty