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General NPI Number Information
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NPI Number | 1477742344
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Entity Type | Organization
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Legal Business Name | GOLDE CHIROPRACTIC CENTER SC
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Dates
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Enumeration Date | 10/17/2007
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Last Update Date | 10/17/2007
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Provider Practice Location Address
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Address Line | 2403 LONDON ROAD
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City | EAU CLAIRE
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State | WI
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Zip | 54701-6731
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Country | US
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Telephone | 715-832-6145
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Fax | 715-832-6136
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Provider Business Mailing Address
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Address Line | 2403 LONDON ROAD
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City | EAU CLAIRE
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State | WI
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Zip | 54701-6731
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Country | US
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Telephone | 715-832-6145
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Fax | 715-832-6136
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Authorized Official
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Title or Position | PRESIDENT
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Name | JAMES MITCHELL CAULDER
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Credential | DC
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Telephone | 715-832-6145
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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 | 3555
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License Number State | MN
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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 | 3619
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License Number State | WI
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