Doctor Name: | DOROTHY LEE TENDERHOLT |
NPI Number: | 1124232038 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DC,ND |
License Number: | CHOOOO2317 |
Business Practice Address: | 12263 N. Mill St. Clearlake, WA - 982350365 |
Business Phone Number: | 3608565354 |
Business Fax Number: | |
Mailing Address: | Po Box 365, CLEARLAKE |
State: | WA |
Postal Code: | 982350365 |
Phone Number: | 3608565354 |
Fax Number: | |
NPI Enumeration Date: | 05/09/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | CHOOOO2317 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
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. |