Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | CH8481 | FL |
NPI | 1386784353 |
---|---|
Provider Name | Dr. Claude D-Charles |
First Address | Tallahassee, FL 32301-5505 |
Second Address | Tallahassee, FL 32301-5505 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2007 |
Last Update Date | 08/07/2007 |