Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 0104001238 | VA |
N | 111NR0400X | Rehabilitation Chiropractor | 0104001238 | VA |
NPI | 1225117013 |
---|---|
Provider Name | Dr. Edwin L. Doan |
First Address | Chesapeake, VA 23323-6441 |
Second Address | Chesapeake, VA 23322-8380 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2006 |
Last Update Date | 15/02/2017 |