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Individual

FRED M. SOUTHARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
860 NW WASHINGTON BLVD, SUITE D, HAMILTON, OH 45013-6382
(513) 868-0978
(513) 868-3014
Mailing address
860 NW WASHINGTON BLVD, SUITE D, HAMILTON, OH 45013-6382
(513) 868-0978
(513) 868-3014

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
720
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0383599
OH
Enumeration date
08/10/2006
Last updated
07/08/2007
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