Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 0000694 | TN |
NPI | 1003037029 |
---|---|
Provider Name | Ralph Owens Stone |
First Address | Columbia, TN 38401 |
Second Address | Columbia, TN 38401 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4342098 | AETNA (01) | |
4440224 | UHC (01) | |
T92451 | (02) |