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General NPI Number Information
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NPI Number | 1194948968
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Entity Type | Organization
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Legal Business Name | PRIEM CHIROPRACTIC AND PHYSICAL THERAPY INC
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 04/01/2011
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Provider Practice Location Address
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Address Line | 661 THIRD ST
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City | NEW MARTINSVILLE
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State | WV
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Zip | 26155-1401
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Country | US
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Telephone | 304-455-6824
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Fax | 304-455-6825
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Provider Business Mailing Address
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Address Line | 661 THIRD ST
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City | NEW MARTINSVILLE
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State | WV
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Zip | 26155-1401
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Country | US
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Telephone | 304-455-6824
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Fax | 304-455-6825
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. EDWARD JAMES PRIEM
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Credential | DC PT DPT
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Telephone | 304-455-6824
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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 | 656
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License Number State | WV
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