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General NPI Number Information
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NPI Number | 1740514090
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Entity Type | Organization
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Legal Business Name | 1ST CHOICE CHIROPRACTIC
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Dates
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Enumeration Date | 09/18/2009
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Last Update Date | 09/18/2009
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Provider Practice Location Address
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Address Line | 1303 DELAWARE AVE SUITE 12
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City | WILMINGTON
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State | DE
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Zip | 19806-3419
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Country | US
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Telephone | 302-543-6072
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Fax | 302-543-6082
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Provider Business Mailing Address
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Address Line | 1303 DELAWARE AVE SUITE 12
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City | WILMINGTON
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State | DE
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Zip | 19806-3419
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Country | US
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Telephone | 302-543-6072
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Fax | 302-543-6082
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. CHARLETTE FLETCHER
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Credential | DC
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Telephone | 302-543-6072
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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 | F10000627
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License Number State | DE
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