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Individual

DR. JOHN SAMUEL IRWIN IV

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
104 POPWELL AVENUE, CLANTON, AL 35045-2324
(205) 755-4430
(205) 755-4472
Mailing address
104 POPWELL AVE, CLANTON, AL 35045-2324
(205) 755-4430
(205) 755-4472

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1994
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
51553204
BCBS OF AL PROVIDER ID
AL
Enumeration date
09/27/2006
Last updated
07/20/2012
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