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General NPI Number Information
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NPI Number | 1922104090
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Entity Type | Organization
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Legal Business Name | COLIN R CADDELL DC PA
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Dates
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Enumeration Date | 09/16/2006
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Last Update Date | 05/02/2008
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Provider Practice Location Address
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Address Line | 3608 W FRIENDLY AVE STE 204
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City | GREENSBORO
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State | NC
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Zip | 27410-4865
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Country | US
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Telephone | 336-294-1273
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Fax | 336-294-1274
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Provider Business Mailing Address
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Address Line | 3608 W FRIENDLY AVE STE 204
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City | GREENSBORO
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State | NC
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Zip | 27410-4865
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Country | US
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Telephone | 336-294-1273
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Fax | 336-294-1274
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. COLIN R CADDELL
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Credential | DC
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Telephone | 336-294-1273
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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 | 1151
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License Number State | NC
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