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General NPI Number Information
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NPI Number | 1538253018
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Entity Type | Individual
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Provider Name | DICK L COCKERILL D.C.
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Gender | Male
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 06/24/2008
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Provider Practice Location Address
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Address Line | 1101 S. MAIN
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City | SCOTT CITY
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State | KS
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Zip | 67871-1824
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Country | US
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Telephone | 620-872-2310
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Fax | 620-872-7038
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Provider Business Mailing Address
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Address Line | 1101 S. MAIN
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City | SCOTT CITY
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State | KS
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Zip | 67871-1824
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | C3292
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License Number State | KS
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