Doctor Name: | CHARLES KIRCHEM |
NPI Number: | 1023341864 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DPT |
License Number: | 07655 |
Business Practice Address: | 12371 Highway 90 Suite D Luling, LA - 700705114 |
Business Phone Number: | 9853311001 |
Business Fax Number: | 9853311005 |
Mailing Address: | 12371 Hwy. 90, Suite D LULING |
State: | LA |
Postal Code: | 70070 |
Phone Number: | 9853311001 |
Fax Number: | 9853311005 |
NPI Enumeration Date: | 09/11/2009 |
NPI Last Update Date: | 08/18/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 07655 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |