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Individual

CLYDE L SHOWN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CHIROPRACTOR

Contact information

Practice address
660 MCQUEEN SMITH RD N STE E, PRATTVILLE, AL 36066-7559
(334) 361-9500
Mailing address
123 BRYAN ST, PRATTVILLE, AL 36066-5340
(334) 361-0955

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0146
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0146
0146
Enumeration date
08/30/2011
Last updated
08/30/2011
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