Provider Demographics
NPI:1720649502
Name:CHIROPRACTIC HEALTH CLINIC OF HUNTSVILLE LLC
Entity type:Organization
Organization Name:CHIROPRACTIC HEALTH CLINIC OF HUNTSVILLE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HUNTER
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:256-682-5695
Mailing Address - Street 1:806 GOVERNORS DR SW STE 102
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-5133
Mailing Address - Country:US
Mailing Address - Phone:256-682-5695
Mailing Address - Fax:256-801-7731
Practice Address - Street 1:806 GOVERNORS DR SW STE 102
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-5133
Practice Address - Country:US
Practice Address - Phone:256-682-5695
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-24
Last Update Date:2019-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NP0017XChiropractic ProvidersChiropractorPediatric ChiropractorGroup - Single Specialty