Healthcare Provider Details

I. General information

NPI: 1659551117
Provider Name (Legal Business Name): CAUDILL & VAN VOORHIS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2007
Last Update Date: 10/30/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1750 SOUTHGATE PKWY
CAMBRIDGE OH
43725-3024
US

IV. Provider business mailing address

128 SOUTHERN MANOR RD
VANCEBURG KY
41179-7511
US

V. Phone/Fax

Practice location:
  • Phone: 740-432-3634
  • Fax:
Mailing address:
  • Phone: 606-796-0385
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: MRS. DONNA J CAUDILL
Title or Position: TREASURER
Credential:
Phone: 606-796-0385