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General NPI Number Information
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NPI Number | 1760560684
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Entity Type | Organization
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Legal Business Name | DR C E BICKERTON DCCC
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 09/01/2010
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Provider Practice Location Address
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Address Line | 333 LINCOLN ST
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City | GRAFTON
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State | WV
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Zip | 26354-1562
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Country | US
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Telephone | 304-265-4200
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Fax | 304-265-4201
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Provider Business Mailing Address
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Address Line | 333 LINCOLN ST
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City | GRAFTON
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State | WV
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Zip | 26354-1562
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Country | US
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Telephone | 304-265-4200
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Fax | 304-265-4201
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CLIFFORD E BICKERTON
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Credential | D.C.
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Telephone | 304-265-4200
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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 | 241
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License Number State | WV
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