Healthcare Provider Details

I. General information

NPI: 1740374024
Provider Name (Legal Business Name): DONALD R MAPLE D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 07/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44 N LONDON ST
MT STERLING OH
43143-1127
US

IV. Provider business mailing address

44 N LONDON ST
MT STERLING OH
43143-1127
US

V. Phone/Fax

Practice location:
  • Phone: 740-869-2800
  • Fax: 740-869-2323
Mailing address:
  • Phone: 740-869-2800
  • Fax: 740-869-2323

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1703
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: