Doctor Name: | MARYBELLE WALDEN |
NPI Number: | 1013113711 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CHIROPRACTOR DC |
License Number: | 5048 |
Business Practice Address: | 450 N Main St Suite 2 Jellico, TN - 377622136 |
Business Phone Number: | 4233720000 |
Business Fax Number: | 4233720000 |
Mailing Address: | 450 N. Main St., Suite 2 JELLICO |
State: | TN |
Postal Code: | 37762 |
Phone Number: | 4233720000 |
Fax Number: | 4233720000 |
NPI Enumeration Date: | 06/21/2007 |
NPI Last Update Date: | 09/09/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | 5048 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | KY |
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. |