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General NPI Number Information
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NPI Number | 1558375352
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Entity Type | Individual
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Provider Name | CHARLES DOUGLAS PIERSOL DC DACRB
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Gender | Male
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Dates
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Enumeration Date | 07/28/2006
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Last Update Date | 10/05/2011
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Provider Practice Location Address
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Address Line | 326 3RD ST
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City | MARIETTA
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State | OH
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Zip | 45750-2994
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Country | US
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Telephone | 740-374-3232
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Fax | 740-374-6387
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Provider Business Mailing Address
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Address Line | PO BOX 965
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City | MARIETTA
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State | OH
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Zip | 45750
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Country | US
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Telephone | 740-374-3232
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Fax | 740-374-6387
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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 | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | 1372
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License Number State | OH
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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 | DC1372
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 479
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License Number State | WV
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