Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | CHIR0006637 | GA |
Y | 111N00000X | Chiropractor | CHIR006637 | GA |
N | 111NI0013X | Independent Medical Examiner | CHIR0006637 | GA |
NPI | 1073722849 |
---|---|
Provider Name | Dr. Elliott Marie Hale |
First Address | Birmingham, AL 35205-3899 |
Second Address | Woodstock, GA 30189-6819 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2007 |
Last Update Date | 05/01/2022 |