Individual
DR. JERRY L CONWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
3689 WATERMELON RD, CAPSTONE CHIROPRACTIC CENTER, NORTHPORT, AL 35473-5139
(205) 758-1600
(205) 758-6698
Mailing address
3689 WATERMELON RD, CAPSTONE CHIROPRACTIC CENTER, NORTHPORT, AL 35473-5139
(205) 758-1600
(205) 758-6698
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
728
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51074208
BLUE CROSS
AL
Enumeration date
09/22/2006
Last updated
07/08/2007
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