Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 004581 | MO |
NPI | 1043354145 |
---|---|
Provider Name | Dr. William E. Tuttle |
First Address | Independence, MO 64055 |
Second Address | Independence, MO 64055 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2007 |
Last Update Date | 14/01/2009 |