Provider Demographics
NPI:1194936211
Name:DUVALL, CHARLES EDWARD JR (DC, MPS MED)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:EDWARD
Last Name:DUVALL
Suffix:JR
Gender:M
Credentials:DC, MPS MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13332 WILLIAMSBURG AVE NW
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44685-8200
Mailing Address - Country:US
Mailing Address - Phone:330-699-0250
Mailing Address - Fax:
Practice Address - Street 1:2307 EAST AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44314-1909
Practice Address - Country:US
Practice Address - Phone:330-745-2141
Practice Address - Fax:330-745-9105
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH770111N00000X, 111NI0013X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111N00000XChiropractic ProvidersChiropractor
Not Answered111NI0013XChiropractic ProvidersChiropractorIndependent Medical Examiner