Southeast Functional Chiropractic

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2403 Issued in AL

Legal business name

SOUTHEAST FUNCTIONAL CHIROPRACTIC

Practice address

1802 US Highway 98
Ste E
Daphne, AL 36526-4861

Phone

(847) 848-5775

NPI assigned

Aug 30, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Wesley Corbin, D.C..

Title

Owner/Doctor

Phone

(847) 848-5775

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1377820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378684800000",
    "number": "1184058745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1802 US HIGHWAY 98",
            "address_2": "STE E",
            "city": "DAPHNE",
            "state": "AL",
            "postal_code": "365264861",
            "telephone_number": "251-375-0012",
            "fax_number": "251-375-0011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 US HIGHWAY 98",
            "address_2": "STE E",
            "city": "DAPHNE",
            "state": "AL",
            "postal_code": "365264861",
            "telephone_number": "847-848-5775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST FUNCTIONAL CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-30",
        "last_updated": "2013-09-09",
        "status": "A",
        "authorized_official_last_name": "CORBIN",
        "authorized_official_first_name": "WESLEY",
        "authorized_official_title_or_position": "OWNER/DOCTOR",
        "authorized_official_telephone_number": "847-848-5775",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C.."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "AL",
            "license": "2403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Daphne, AL
• Providers in Daphne, AL by specialty
• Chiropractor in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.