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General NPI Number Information
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NPI Number | 1851486773
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Entity Type | Organization
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Legal Business Name | LATTIMER CHIROPRACTIC CLINIC
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 04/10/2008
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Provider Practice Location Address
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Address Line | RT 20 PROFESSIONAL ARTS PLAZA
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City | BUCKHANNON
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State | WV
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Zip | 26201-0551
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Country | US
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Telephone | 304-472-6393
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Fax | 304-472-6485
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Provider Business Mailing Address
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Address Line | PO BOX 551
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City | BUCKHANNON
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State | WV
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Zip | 26201-0551
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Country | US
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Telephone | 304-472-6393
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Fax | 304-472-6485
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | MR. BRIAN J LATTIMER
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Credential |
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Telephone | 304-472-6393
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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 | 725
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License Number State | WV
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