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Individual

CALLIE HOWISON RADER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DC

Contact information

Practice address
923 EMERSON AVE, PARKERSBURG, WV 26104-2526
(304) 428-9355
(304) 428-2565
Mailing address
923 EMERSON AVE, PARKERSBURG, WV 26104-2526
(304) 428-9355
(304) 428-2565

Taxonomy

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

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001712610
BCBS
WV
01
0895573
MEDICARE PTAN
WV
01
1063297
COMP
WV
05
2202096000
WV
Enumeration date
11/24/2006
Last updated
03/20/2015
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