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General NPI Number Information
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NPI Number | 1457167918
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Entity Type | Organization
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Legal Business Name | NORTHWEST CHIROPRACTIC PLLC
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Dates
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Enumeration Date | 12/09/2024
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Last Update Date | 12/09/2024
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Provider Practice Location Address
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Address Line | 172 S MAIN ST
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City | SAINT ALBANS
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State | VT
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Zip | 05478-1801
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Country | US
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Telephone | 802-432-9095
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 64
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City | BAKERSFIELD
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State | VT
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Zip | 05441-0064
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Country | US
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Telephone | 802-432-9095
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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. ELIZABETH HORNE
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Credential | DC
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Telephone | 802-989-2682
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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 |
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License Number State |
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