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General NPI Number Information
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NPI Number | 1063519627
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Entity Type | Organization
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Legal Business Name | METTLER FAMILY CHIROPRACTIC PA
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Dates
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Enumeration Date | 09/17/2006
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Last Update Date | 10/30/2012
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Provider Practice Location Address
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Address Line | 105 S BROADWAY ST
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City | SPRING VALLEY
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State | MN
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Zip | 55975-1227
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Country | US
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Telephone | 507-346-1077
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Fax | 507-346-7117
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Provider Business Mailing Address
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Address Line | 105 S BROADWAY ST
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City | SPRING VALLEY
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State | MN
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Zip | 55975-1227
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Country | US
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Telephone | 507-346-1077
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Fax | 507-346-7117
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Authorized Official
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Title or Position | SECRATARY - TREASURER
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Name | DR. WILLIAM CECIL METTLER
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Credential | D.C.
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Telephone | 507-346-1077
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 1629386-2
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License Number State | MN
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