Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 005421 | MO |
NPI | 1003130824 |
---|---|
Provider Name | David S Powers |
First Address | Butler, MO 64730-2135 |
Second Address | Butler, MO 64730-2135 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2010 |
Last Update Date | 23/03/2010 |