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General NPI Number Information
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NPI Number | 1477709400
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Entity Type | Organization
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Legal Business Name | VITAMIN DOCTOR WELLNESS & CHIROPRACTIC CTR. P.C.
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Dates
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Enumeration Date | 08/11/2008
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Last Update Date | 12/02/2008
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Provider Practice Location Address
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Address Line | 161 OLD ROUTE 30 STE 3
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City | GREENSBURG
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State | PA
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Zip | 15601-7553
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Country | US
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Telephone | 724-850-7550
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Fax | 724-850-7550
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Provider Business Mailing Address
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Address Line | 161 OLD ROUTE 30 STE 3
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City | GREENSBURG
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State | PA
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Zip | 15601-7553
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Country | US
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Telephone | 724-850-7550
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Fax | 724-850-7550
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RICHARD K. MARSHALL
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Credential | DC
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Telephone | 724-850-7550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | DC4240
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License Number State | PA
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