Organization
CENTRAL ALABAMA SPINE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DESHAN SHERARD GROSS DC (MEMBER)
(205) 655-2277
Entity
Organization
Contact information
Practice address
52 MEDICAL PARK DR E, SUITE 219, BIRMINGHAM, AL 35235-3430
(205) 655-2277
(205) 655-6037
Mailing address
PO BOX 1198, TRUSSVILLE, AL 35173-6100
(205) 655-2277
(205) 655-6037
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
1151
AL
111N00000X
Chiropractor
Primary
2065
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1215086103
NPI
AL
01
—
1972652865
NPI
AL
01
—
4408799
AETNA
AL
01
—
7009708
AETNA
AL
01
—
P00263210
LEGACY
AL
01
—
P00292774
LEGACY
AL
Enumeration date
06/18/2009
Last updated
01/10/2012
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