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General NPI Number Information
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NPI Number | 1265601678
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Entity Type | Individual
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Provider Name | ROGER C LEDLOW DC
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Gender | Male
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Dates
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Enumeration Date | 02/29/2008
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Last Update Date | 02/29/2008
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Provider Practice Location Address
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Address Line | 3116 CAPITAL CIR NE STE 1
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City | TALLAHASSEE
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State | FL
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Zip | 32308-7791
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Country | US
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Telephone | 850-668-7062
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Fax | 850-386-5795
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Provider Business Mailing Address
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Address Line | 3116 CAPITAL CIR NE STE 1
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City | TALLAHASSEE
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State | FL
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Zip | 32308-7791
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Country | US
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Telephone | 850-668-7062
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Fax | 850-386-5795
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NX0800X
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Taxonomy Name | Orthopedic Chiropractor
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License Number | CH5784
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License Number State | FL
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