MEDICARE: DAWN INJURY & WELLNESS CENTER PLLC

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	720	WV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1063297	OTHER	WV	WORKER'S COMPENSATION
2	001712610	OTHER	WV	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	7776862	OTHER	WV	CIGNA

General Provider Information

NPI Number	:	1932318573
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAWN INJURY & WELLNESS CENTER PLLC

Provider Business Mailing Address
First Line	:	923 EMERSON AVE
Second Line	:
City	:	PARKERSBURG
State	:	WV
Zip	:	26101-2526
Country	:	US
Telephone Number	:	304-428-9355
Fax Number	:	304-428-2565

Provider Business Practice Location Address
First Line	:	923 EMERSON AVE
Second Line	:
City	:	PARKERSBURG
State	:	WV
Zip	:	26101-2526
Country	:	US
Telephone Number	:	304-428-9355
Fax Number	:	304-428-2565

Authorized Official
Title or Position	:	CHIROPRACTOR/OWNER
Name	:	DR. CALLIE RADER
Credential	:	DC
Telephone Number	:	304-428-9355

Provider Enumeration Date	:	05/21/2007
Last Update Date	:	02/24/2015

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Directions to “DAWN INJURY & WELLNESS CENTER PLLC ” Practice Location

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