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General NPI Number Information
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NPI Number | 1770806366
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Entity Type | Organization
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Legal Business Name | WADE CLINIC OF CHIROPRACTIC, PC
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Dates
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Enumeration Date | 03/10/2010
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Last Update Date | 03/10/2010
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Provider Practice Location Address
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Address Line | 620 QUINTARD DR SUITE 201
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City | OXFORD
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State | AL
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Zip | 36203-1840
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Country | US
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Telephone | 256-237-9423
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Fax | 256-237-6007
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Provider Business Mailing Address
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Address Line | 620 QUINTARD DR SUITE 201
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City | OXFORD
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State | AL
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Zip | 36203-1840
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Country | US
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Telephone | 256-237-9423
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Fax | 256-237-6007
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Authorized Official
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Title or Position | OWNER
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Name | DR. DAVID E WADE
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Credential | DC
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Telephone | 256-237-9423
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 1059
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License Number State | AL
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