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General NPI Number Information
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NPI Number | 1104331685
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Entity Type | Organization
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Legal Business Name | TICKEL CHIROPRACTIC AND DECOMPRESSION PLLC
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Dates
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Enumeration Date | 12/06/2017
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Last Update Date | 12/06/2017
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Provider Practice Location Address
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Address Line | 409 8TH ST NE
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22902-4727
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Country | US
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Telephone | 434-260-6463
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Fax |
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Provider Business Mailing Address
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Address Line | 409 8TH ST NE
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22902-4727
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Country | US
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Telephone | 434-260-6463
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JAMES W TICKEL
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Credential | DC
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Telephone | 434-260-6463
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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 |
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License Number State |
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