Organization
DIFFENDERFER ENTERPRISES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FRED E DIFFENDERFER D.C. (PRESIDENT)
(740) 474-9777
Entity
Organization
Contact information
Practice address
1430 N COURT ST, CIRCLEVILLE, OH 43113-1005
(740) 474-9777
(740) 474-6225
Mailing address
1430 N COURT ST, CIRCLEVILLE, OH 43113-1005
(740) 474-9777
(740) 474-6225
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC1077
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000120712
GROUP ANTHEM
OH
01
—
168369204002
MEDICAL MUTUAL
OH
Enumeration date
05/22/2007
Last updated
08/20/2010
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