Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 862 | AL |
NPI | 1265448914 |
---|---|
Provider Name | Dr. Michael J Plaxco SR. |
First Address | Muscle Shoals, AL 35661-1666 |
Second Address | Muscle Shoals, AL 35661-1666 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2006 |
Last Update Date | 08/07/2007 |