Healthcare Provider Details

I. General information

NPI: 1952332363
Provider Name (Legal Business Name): DR. K. MICHAEL KING CHRIOPRACTOR PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 04/08/2022
Certification Date: 04/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1137 E MAIN ST
LURAY VA
22835-1683
US

IV. Provider business mailing address

1137 E MAIN ST
LURAY VA
22835-1683
US

V. Phone/Fax

Practice location:
  • Phone: 540-743-3333
  • Fax: 540-743-1425
Mailing address:
  • Phone: 540-743-3333
  • Fax: 540-743-1425

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number0104556076
License Number StateVA

VIII. Authorized Official

Name: DR. KEITH MICHAEL KING
Title or Position: OWNER/PROVIDER
Credential: DC
Phone: 540-743-3333