Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 0104001664 | VA |
NPI | 1043365190 |
---|---|
Provider Name | Dr. John Richard Doepper |
First Address | Winchester, VA 22602-6801 |
Second Address | Winchester, VA 22602-4300 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/01/2007 |
Last Update Date | 09/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
249691 | ANTHEM (01) | VA |