Healthcare Provider Details

I. General information

NPI: 1477747558
Provider Name (Legal Business Name): KEYSVILLE CHIROPRACTIC PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2007
Last Update Date: 11/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

176 KING STREET
KEYSVILLE VA
23947-5103
US

IV. Provider business mailing address

PO BOX 136
KEYSVILLE VA
23947-0136
US

V. Phone/Fax

Practice location:
  • Phone: 434-736-9895
  • Fax: 434-736-9897
Mailing address:
  • Phone: 434-315-5868
  • Fax: 434-315-5989

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number0104556537
License Number StateVA

VIII. Authorized Official

Name: DR. MATTHEW M SCHRIER
Title or Position: MEMBER
Credential: D.C.
Phone: 434-315-5868