Doctor Name: | DR. MARK T DRENTLAW |
NPI Number: | 1073765137 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DC |
License Number: | 2294 |
Business Practice Address: | 562 Harmon Loop Rd Box 129 Dededo, GU - 969296538 |
Business Phone Number: | 6716378901 |
Business Fax Number: | 6716378906 |
Mailing Address: | 562 Harmon Loop Rd, Box 129 DEDEDO |
State: | GU |
Postal Code: | 969296538 |
Phone Number: | 6716378901 |
Fax Number: | 6716378906 |
NPI Enumeration Date: | 10/21/2008 |
NPI Last Update Date: | 12/10/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | 2294 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
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. |