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General NPI Number Information
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NPI Number | 1447459078
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Entity Type | Organization
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Legal Business Name | CHARLES D PRICE
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Dates
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Enumeration Date | 07/13/2007
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Last Update Date | 09/10/2008
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Provider Practice Location Address
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Address Line | 102 S SECTION ST
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City | SULLIVAN
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State | IN
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Zip | 47882-1805
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Country | US
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Telephone | 812-268-3313
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Fax |
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Provider Business Mailing Address
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Address Line | 3120 N CROSS ST ROBINSON CHIROPRACTIC SERVICES
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City | ROBINSON
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State | IN
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Zip | 62454
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Country | US
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Telephone | 618-544-3551
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. CHARLES DONALD PRICE
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Credential | DC
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Telephone | 812-268-3313
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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 | 08001177
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License Number State | IN
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