Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 08000818A | IN |
NPI | 1063561793 |
---|---|
Provider Name | Dr. Wiliam George Garl |
First Address | Bremen, IN 46506-1238 |
Second Address | Bremen, IN 46506-1238 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
351928144 | FEDERAL ID NUMBER (01) | IN |