Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 2828 | OH |
NPI | 1003841131 |
---|---|
Provider Name | Donna C. Allen |
First Address | Springfield, OH 45504-1706 |
Second Address | Springfield, OH 45504-1706 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2143399 | (05) | OH |
U77711 | (02) | OH |