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General NPI Number Information
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NPI Number | 1740334093
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Entity Type | Organization
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Legal Business Name | ELK RIVER CHIROPRACTIC CENTER INC
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 02/19/2014
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Provider Practice Location Address
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Address Line | 615 ELK ST
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City | GASSAWAY
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State | WV
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Zip | 26624-1135
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Country | US
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Telephone | 304-364-5225
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Fax | 304-364-8033
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Provider Business Mailing Address
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Address Line | 615 ELK ST
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City | GASSAWAY
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State | WV
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Zip | 26624-1135
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Country | US
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Telephone | 304-364-5225
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Fax | 304-364-8033
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Authorized Official
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Title or Position | OWNER
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Name | MR. WILLIAM DWIGHT LOHR JR.
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Credential | DC
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Telephone | 304-364-5225
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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 |
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License Number State |
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