Doctor Name: | DR. CHARLENE R STODDARD |
NPI Number: | 1114922739 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | D.C. |
License Number: | CHIA-819 |
Business Practice Address: | 1025 W Ironwood Dr Ste 2 Coeur D Alene, ID - 838143161 |
Business Phone Number: | 2086670875 |
Business Fax Number: | 2086672850 |
Mailing Address: | 1025 W Ironwood Dr, Ste 2 COEUR D ALENE |
State: | ID |
Postal Code: | 838143161 |
Phone Number: | 2086670875 |
Fax Number: | 2086672850 |
NPI Enumeration Date: | 06/20/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | CHIA-819 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ID |
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. |