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Individual
CHARLES DOUGLAS PIERSOL
Active
Individual
CHARLES DOUGLAS PIERSOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC DACRB
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
479
WV
111N00000X
Chiropractor
Primary
DC1372
OH
111NR0400X
Rehabilitation Chiropractor
1372
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000153108
ANTHEM
—
01
—
000000153109
ANTHEM
—
01
—
000000191919
UNITED HEALTH CARE MEDICAID
OH
01
—
000194827
MOUNTAIN STATE BCBS
—
01
—
0131222000
UNISYS
WV
05
—
0690766
—
OH
01
—
23288676004
MEDICAL MUTUAL
—
01
—
4352320
AETNA
—
01
—
55067803701
WV WORKERS COMP
—
01
—
W01372A
HEALTH PLAN
—
Enumeration date
07/28/2006
Last updated
10/05/2011
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