Healthcare Provider Details

I. General information

NPI: 1376390856
Provider Name (Legal Business Name): TRAIL TOWN CHIROPRACTIC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2024
Last Update Date: 06/12/2025
Certification Date: 06/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 S SHADY AVE
DAMASCUS VA
24236-3128
US

IV. Provider business mailing address

560 BOWLIN ST
DAMASCUS VA
24236-2317
US

V. Phone/Fax

Practice location:
  • Phone: 276-525-2380
  • Fax:
Mailing address:
  • Phone: 276-525-2380
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. THOMAS RAYMOND FOLTZ JR.
Title or Position: PRESIDENT
Credential: DC
Phone: 276-525-2380