Provider Demographics
NPI:1528245362
Name:JOHN S. IRWIN, D.C., P.C.
Entity type:Organization
Organization Name:JOHN S. IRWIN, D.C., P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:SAMUEL
Authorized Official - Last Name:IRWIN
Authorized Official - Suffix:IV
Authorized Official - Credentials:DC
Authorized Official - Phone:205-755-4430
Mailing Address - Street 1:507 2ND AVE S
Mailing Address - Street 2:
Mailing Address - City:CLANTON
Mailing Address - State:AL
Mailing Address - Zip Code:35045-3513
Mailing Address - Country:US
Mailing Address - Phone:205-755-4430
Mailing Address - Fax:205-755-4472
Practice Address - Street 1:507 2ND AVE S
Practice Address - Street 2:
Practice Address - City:CLANTON
Practice Address - State:AL
Practice Address - Zip Code:35045-3513
Practice Address - Country:US
Practice Address - Phone:205-755-4430
Practice Address - Fax:205-755-4472
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-23
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1994111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty