Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 1085 | AL |
NPI | 1003905977 |
---|---|
Provider Name | Dr. Michael Joseph Chenoweth |
First Address | Mobile, AL 36693-3119 |
Second Address | Mobile, AL 36693-3119 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2006 |
Last Update Date | 19/07/2013 |