Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | 564 | TN |
NPI | 1346435864 |
---|---|
Provider Name | Toni D Chadwick |
First Address | Salem, VA 24153-6404 |
Second Address | Salem, VA 24153-6404 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/09/2007 |
Last Update Date | 07/08/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U76992 | (02) | TN |