MEDICARE: MESSIAH & SON, INC.

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
1	111N00000X	Chiropractor	0104000492	VA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DG9138	OTHER	VA	RAILROAD MEDICARE GROUP NUMBER

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	043306	OTHER	VA	ANTHEM BCBS

General Provider Information

NPI Number	:	1649381005
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MESSIAH & SON, INC.

Provider Business Mailing Address
First Line	:	1917 LASKIN RD
Second Line	:	SUITE 108
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23454-4283
Country	:	US
Telephone Number	:	757-491-4600
Fax Number	:	757-491-0578

Provider Business Practice Location Address
First Line	:	1917 LASKIN RD
Second Line	:	SUITE 108
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23454-4283
Country	:	US
Telephone Number	:	757-491-4600
Fax Number	:	757-491-0578

Authorized Official
Title or Position	:	OWNER
Name	:	DR. DONALD PATRICK BRESNAHAN
Credential	:	D.C.
Telephone Number	:	757-491-4600

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	04/25/2008

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Directions to “MESSIAH & SON, INC. ” Practice Location

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