Provider Demographics
NPI:1871693465
Name:HUTCHINSON, MISTY L (DC)
Entity type:Individual
Prefix:
First Name:MISTY
Middle Name:L
Last Name:HUTCHINSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6467 FARMDALE RD
Mailing Address - Street 2:
Mailing Address - City:BARBOURSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25504-1305
Mailing Address - Country:US
Mailing Address - Phone:304-736-2050
Mailing Address - Fax:304-736-3570
Practice Address - Street 1:6467 FARMDALE RD
Practice Address - Street 2:
Practice Address - City:BARBOURSVILLE
Practice Address - State:WV
Practice Address - Zip Code:25504-1305
Practice Address - Country:US
Practice Address - Phone:304-736-2050
Practice Address - Fax:304-736-3570
Is Sole Proprietor?:No
Enumeration Date:2006-09-23
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV724111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVU90600Medicare UPIN