Individual provider · Type 1 NPI
Charles Robert Portwood, DC
Chiropractor · Scott Afb, IL
NPI number
1689611576
Active
Practice location
310 W Losey St
Scott Afb, IL 62225-5250
Fax (618) 256-7931
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Chiropractor Primary | 111N00000X | 6006 (MO) |
Chiropractor: A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
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About NPI 1689611576
Charles Robert Portwood, DC's National Provider Identifier is 1689611576, issued on Jun 1, 2006. The primary taxonomy on file is Chiropractor (111N00000X), and the practice location is in Scott Afb, IL. The record was last updated on Aug 7, 2024.