MEDICARE: DR. DUANE E. HUDSPATH DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	0104001281	VA

General Provider Information

NPI Number	:	1174662076
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DUANE E. HUDSPATH DC

Provider Business Mailing Address
First Line	:	5436 MAIN ST
Second Line	:
City	:	STEPHENS CITY
State	:	VA
Zip	:	22655-2829
Country	:	US
Telephone Number	:	540-869-3034
Fax Number	:	540-869-0195

Provider Business Practice Location Address
First Line	:	5436 MAIN ST
Second Line	:
City	:	STEPHENS CITY
State	:	VA
Zip	:	22655-2829
Country	:	US
Telephone Number	:	540-869-3034
Fax Number	:	540-869-0195

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/06/2007
Last Update Date	:	07/08/2007

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