Healthcare Provider Details

I. General information

NPI: 1306029657
Provider Name (Legal Business Name): TOWNE & COUNTRY CHIROPRACTIC, LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2007
Last Update Date: 02/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6091 GEORGE WASHINGTON MEMORIAL HWY
GLOUCESTER VA
23061-3750
US

IV. Provider business mailing address

6091 GEORGE WASHINGTON MEMORIAL HWY
GLOUCESTER VA
23061-3750
US

V. Phone/Fax

Practice location:
  • Phone: 804-693-0093
  • Fax: 804-693-6311
Mailing address:
  • Phone: 804-693-0093
  • Fax: 804-693-6311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number0104000677
License Number StateVA

VIII. Authorized Official

Name: DR. LAYTON WILLIAM MERITHEW
Title or Position: OWNER/DOCTOR
Credential: D.C.
Phone: 804-693-0093