Organization
THREE NOTCH CHIROPRACTIC, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES JONATHAN RALEY IV D.C. (OWNER)
(334) 352-4019
Entity
Organization
Contact information
Practice address
504 E THREE NOTCH ST, ANDALUSIA, AL 36420-3128
(334) 352-4019
(334) 352-4019
Mailing address
PO BOX 1093, ANDALUSIA, AL 36420-1222
(334) 352-4019
(334) 352-4019
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2242
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51548679
BLUE CROSS BLUE SHIELD OF ALABAMA
AL
Enumeration date
08/08/2008
Last updated
08/08/2008
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