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General NPI Number Information
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NPI Number | 1326111071
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Entity Type | Organization
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Legal Business Name | COMMONWEALTH CHIROPRACTIC CENTER PSC
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Dates
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Enumeration Date | 11/17/2006
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Last Update Date | 06/30/2014
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Provider Practice Location Address
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Address Line | 1827 KY ROUTE 321
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City | PRESTONSBURG
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State | KY
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Zip | 41653-9102
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Country | US
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Telephone | 606-889-9222
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Fax | 606-886-1605
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Provider Business Mailing Address
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Address Line | 1827 KY ROUTE 321
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City | PRESTONSBURG
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State | KY
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Zip | 41653-9102
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Country | US
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Telephone | 606-889-9222
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Fax | 606-886-1605
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. CHARLES R. SALYERS II
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Credential | DC
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Telephone | 606-889-9222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 4265
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 4265
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License Number State | KY
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