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NPI Code Detail

MEDICARE: GLEN ALLEN CHIROPRACTIC & ACUPUNCTURE CENTER PC

MEDICARE: GLEN ALLEN CHIROPRACTIC & ACUPUNCTURE CENTER PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor0104001916VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11942209556OTHERVAINDIVIDUAL NPI #

General Provider Information

NPI Number : 1306907399
Entity Type Code : Organization
Provider Name (Legal Business Name) : GLEN ALLEN CHIROPRACTIC & ACUPUNCTURE CENTER PC
Provider Business Mailing Address
First Line : 11535 NUCKOLS RD STE D
Second Line :
City : GLEN ALLEN
State : VA
Zip : 23059-5671
Country : US
Telephone Number : 804-747-5464
Fax Number : 804-747-5483
Provider Business Practice Location Address
First Line : 11535 NUCKOLS RD STE D
Second Line :
City : GLEN ALLEN
State : VA
Zip : 23059-5671
Country : US
Telephone Number : 804-747-5464
Fax Number : 804-747-5483
Authorized Official
Title or Position : OFFICE MANAGER
Name : MR. MICHAEL SPAGNOLO
Credential :
Telephone Number : 804-747-5464
Provider Enumeration Date : 12/13/2006
Last Update Date : 08/26/2014

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Directions to “GLEN ALLEN CHIROPRACTIC & ACUPUNCTURE CENTER PC ” Practice Location

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