Healthcare Provider Details

I. General information

NPI: 1679808174
Provider Name (Legal Business Name): DR KRAWCHUK PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2009
Last Update Date: 10/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

322 N BUCKMARSH ST
BERRYVILLE VA
22611-1000
US

IV. Provider business mailing address

322 N BUCKMARSH ST
BERRYVILLE VA
22611-1000
US

V. Phone/Fax

Practice location:
  • Phone: 540-955-3355
  • Fax:
Mailing address:
  • Phone: 540-955-3355
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number0104556190
License Number StateVA

VIII. Authorized Official

Name: DR. CELESTE MARIE KRAWCHUK
Title or Position: OWNER
Credential: D.C.
Phone: 540-327-2434