=====================================================
General NPI Number Information
=====================================================
NPI Number | 1487016275
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | GEORGE H POSTLETHWAITE DC PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/22/2016
-----------------------------------------------------
Last Update Date | 04/10/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 801 W MAPLE ST
-----------------------------------------------------
City | RAWLINS
-----------------------------------------------------
State | WY
-----------------------------------------------------
Zip | 82301-5448
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 307-324-7000
-----------------------------------------------------
Fax | 307-328-2150
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 801 W MAPLE ST
-----------------------------------------------------
City | RAWLINS
-----------------------------------------------------
State | WY
-----------------------------------------------------
Zip | 82301-5448
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 307-324-7000
-----------------------------------------------------
Fax | 307-328-2150
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. GEORGE H POSTLETHWAITE
-----------------------------------------------------
Credential | D.C.
-----------------------------------------------------
Telephone | 307-324-7000
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 751
-----------------------------------------------------
License Number State | WY
-----------------------------------------------------