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General NPI Number Information
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NPI Number | 1225349707
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Entity Type | Organization
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Legal Business Name | HALL OF FAME CHIROPRACTIC &
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Dates
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Enumeration Date | 06/29/2010
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Last Update Date | 08/25/2010
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Provider Practice Location Address
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Address Line | 416 37TH ST
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City | PARKERSBURG
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State | WV
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Zip | 26101-1009
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Country | US
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Telephone | 304-865-4255
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Fax | 304-865-4258
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Provider Business Mailing Address
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Address Line | 416 37TH ST
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City | PARKERSBURG
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State | WV
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Zip | 26101-1009
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Country | US
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Telephone | 304-865-4255
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Fax | 304-865-4258
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Authorized Official
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Title or Position | OWNER
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Name | DR. DAVID R HALL
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Credential | DC
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Telephone | 304-865-4255
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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 | 794
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License Number State | WV
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