Organization
DR C E BICKERTON DCCC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CLIFFORD E BICKERTON D.C. (PRESIDENT)
(304) 265-4200
Entity
Organization
Contact information
Practice address
333 LINCOLN ST, GRAFTON, WV 26354-1562
(304) 265-4200
(304) 265-4201
Mailing address
333 LINCOLN ST, GRAFTON, WV 26354-1562
(304) 265-4200
(304) 265-4201
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
241
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001719992
BCBS
WV
05
—
0131359000
—
WV
01
—
1022682
BRICKSTREET VENDOR NO.
WV
01
—
1316941651
NPI
WV
Enumeration date
11/01/2006
Last updated
09/01/2010
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