Dr. Michael R. Condaras DCCC

Organization Active NPI Chiropractor · Charleston, WV

NPI 1376816629 · NPPES record last updated Feb 17, 2012

Key facts

NPI
1376816629
Entity type
Organization (NPI type 2)
Primary specialty
Chiropractor 111N00000X
License
161 (WV)
Legal business name
DR. MICHAEL R. CONDARAS DCCC
Practice address
1202 Virginia St E
Charleston, WV 25301-2909
Phone
(304) 342-3323
Fax
(304) 342-3357
NPI assigned
Feb 17, 2012
Organization subpart
No

Authorized official

Name
Dr. Michael R Condaras, DCCC
Title
Chiropractor
Phone
(304) 342-3323

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

1202 Virginia St E
Charleston, WV 25301
Phone (304) 342-3323

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor
Group: 193400000X SINGLE SPECIALTY GROUP
111N00000X 161 WV Yes

Addresses

Primary practice location

1202 Virginia St E
Charleston, WV 25301-2909

Mailing address

1202 Virginia St E
Charleston, WV 25301-2909
Phone (304) 342-3323

Other identifiers

IdentifierTypeStateIssuer
0131291000MedicaidWV
CO 0383813OtherWVMEDICARE ID- TYPE UNSPECIFIED

Other providers in Charleston, WV

All providers in Charleston, WV · Chiropractor in West Virginia

Sources for this page

Verify at the official NPI Registry.