Provider Demographics
NPI:1023340502
Name:DONNELLY, LOIS A (DC)
Entity type:Individual
Prefix:
First Name:LOIS
Middle Name:A
Last Name:DONNELLY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 OFFICE PARK CIR
Mailing Address - Street 2:SUITE 203
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35223-2512
Mailing Address - Country:US
Mailing Address - Phone:205-427-1894
Mailing Address - Fax:
Practice Address - Street 1:6 OFFICE PARK CIR
Practice Address - Street 2:SUITE 203
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35223-2512
Practice Address - Country:US
Practice Address - Phone:205-427-1894
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-08
Last Update Date:2010-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1814111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor