Organization Name: | ETHERIDGE CHIROPRACTIC CLINIC INC |
NPI Number: | 1003003534 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | EUGENE W ETHERIDGE (DOCTOR) |
Mailing Address: | 631 S 25th Street Terre Haute |
State: | IN US |
Postal Code: | 47803 |
Phone Number: | 8122328803 |
Fax Number: | 8122321305 |
NPI Enumeration Date: | 09/28/2007 |
NPI Last Update Date: | 07/10/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | 01/09/2008 |
NPI Reactivation Date: | 07/10/2009 |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | 08001352 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Chiropractic Providers |
Taxonomy Classification: | Chiropractor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |