Organization · NPI-2

Accident Spine & Rehab

Chiropractor, Rehabilitation · Birmingham, AL

NPI number1649691858
StatusActive
Last updated in NPPESAug 20, 2015

Details

NPI
1649691858
Entity type
Organization (NPI-2)
Legal business name
Accident Spine & Rehab
Organization subpart
No
Enumeration date
Dec 16, 2013
Last updated
Aug 20, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
111NR0400X Chiropractor, Rehabilitation2100ALYes

Practice location

1401 3rd Ave W
Suite 108
Birmingham, AL 35208-5300

Phone 205-561-6015 · Fax 205-957-6740

Mailing address

819 Mimosa Park Rd
Tuscaloosa, AL 35405-4839

Phone 205-561-6015

Authorized official

Brent Alan Tidwell
President
2055616015

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