Healthcare Provider Details

I. General information

NPI: 1336226133
Provider Name (Legal Business Name): WILLIAM DWIGHT LOHR JR. D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 02/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

615 ELK ST
GASSAWAY WV
26624-1135
US

IV. Provider business mailing address

HC 61 BOX 58B
FRAMETOWN WV
26623-9402
US

V. Phone/Fax

Practice location:
  • Phone: 304-364-5225
  • Fax:
Mailing address:
  • Phone: 304-364-5396
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number337
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: