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General NPI Number Information
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NPI Number | 1831815695
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Entity Type | Organization
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Legal Business Name | MANSFIELD ACCIDENT & INJURY CENTER, LLC
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Dates
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Enumeration Date | 10/13/2022
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Last Update Date | 10/13/2022
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Provider Practice Location Address
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Address Line | 432 S MAIN ST
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City | MANSFIELD
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State | OH
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Zip | 44907-5002
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Country | US
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Telephone | 419-522-4672
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Fax |
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Provider Business Mailing Address
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Address Line | 128 SOUTHERN MANOR RD
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City | VANCEBURG
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State | KY
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Zip | 41179-7511
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Country | US
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Telephone | 740-302-2744
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Fax |
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Authorized Official
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Title or Position | TREASURER
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Name | MRS. DONNA CAUDILL
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Credential |
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Telephone | 740-302-2744
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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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