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General NPI Number Information
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NPI Number | 1225105554
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Entity Type | Organization
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Legal Business Name | C S WYNN D C CHIROPRACTIC OFFICES INC
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Dates
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Enumeration Date | 11/30/2006
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Last Update Date | 04/08/2013
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Provider Practice Location Address
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Address Line | 1080 N IRWIN ST
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City | HANFORD
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State | CA
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Zip | 93230-2949
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Country | US
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Telephone | 559-582-2684
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Fax | 559-582-9275
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Provider Business Mailing Address
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Address Line | 1080 N IRWIN ST
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City | HANFORD
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State | CA
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Zip | 93230-2949
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Country | US
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Telephone | 559-582-2684
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Fax | 559-582-9275
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | MS. CHARLES S WYNN
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Credential | DC
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Telephone | 559-582-2684
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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 | DC09970
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License Number State | CA
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