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General NPI Number Information
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NPI Number | 1164898268
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Entity Type | Organization
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Legal Business Name | OAKWOOD FAMILY CHIROPRACTIC LLC
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Dates
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Enumeration Date | 08/12/2015
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Last Update Date | 11/17/2015
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Provider Practice Location Address
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Address Line | 411 HAKES ST
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City | OAKWOOD
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State | OH
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Zip | 45873-0006
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Country | US
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Telephone | 419-594-3378
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Fax | 419-594-3379
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Provider Business Mailing Address
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Address Line | PO BOX 6
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City | OAKWOOD
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State | OH
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Zip | 45873-0006
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Country | US
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Telephone | 419-594-3378
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Fax | 419-594-3379
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Authorized Official
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Title or Position | OWNER/DC
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Name | DR. DANIELLE NICOLE MATSON
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Credential | DC
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Telephone | 419-594-3378
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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 | 4391
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License Number State | OH
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