Healthcare Provider Details

I. General information

NPI: 1518976521
Provider Name (Legal Business Name): CHIROPRACTIC CENTERS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2006
Last Update Date: 05/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10002 COURTVIEW LN
CHESTERFIELD VA
23832-6678
US

IV. Provider business mailing address

10002 COURTVIEW LN
CHESTERFIELD VA
23832-6678
US

V. Phone/Fax

Practice location:
  • Phone: 804-748-5748
  • Fax: 804-523-8013
Mailing address:
  • Phone: 804-748-5748
  • Fax: 804-523-8013

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number104001445
License Number StateVA

VIII. Authorized Official

Name: DR. MICHAEL T MCCARNEY
Title or Position: PRESIDENT
Credential: DC
Phone: 804-608-3040