Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 733 | OH |
NPI | 1770618050 |
---|---|
Provider Name | Dr. Max Lee Denton I |
First Address | Marion, OH 43302-4260 |
Second Address | Marion, OH 43302-4260 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/02/2007 |
Last Update Date | 21/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0433043 | (05) | OH |
T47062 | (02) | OH |