| NPI | 1972160422 | 
|---|---|
| Former Legal Business Name | HADDOCK CHIROPRACTIC | 
| Entity Type | Organization | 
| Authorized Contact | JILL R SORRELLS CFO 478-237-6262 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) | 
| Enumeration Date | 2019-05-21 | 
| Last Update Date | 2019-05-21 |