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NPI Code Detail

MEDICARE: CALLIE HOWISON RADER DC

MEDICARE: CALLIE HOWISON RADER 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
1111N00000XChiropractor720WV

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10895573OTHERWVMEDICARE PTAN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
31063297OTHERWVCOMP
4001712610OTHERWVBCBS

General Provider Information

NPI Number : 1982770830
Entity Type Code : Individual
Provider Name (Legal Business Name) : CALLIE HOWISON RADER DC
Provider Business Mailing Address
First Line : 923 EMERSON AVE
Second Line :
City : PARKERSBURG
State : WV
Zip : 26104-2526
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 : 26104-2526
Country : US
Telephone Number : 304-428-9355
Fax Number : 304-428-2565
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/24/2006
Last Update Date : 03/20/2015

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Directions to “ CALLIE HOWISON RADER DC” Practice Location

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