Healthcare Provider Details
I. General information
NPI: 1720159718
Provider Name (Legal Business Name): HUTTON CHIROPRACTIC HEALTH CENTER OF MARSHALL PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/13/2006
Last Update Date: 09/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8430 WEST MAIN STREET
MARSHALL VA
20115
US
IV. Provider business mailing address
PO BOX 1053
MARSHALL VA
20116
US
V. Phone/Fax
- Phone: 540-364-2045
- Fax: 540-364-3860
- Phone: 540-364-2045
- Fax: 540-364-3860
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 0104000463 |
| License Number State | VA |
VIII. Authorized Official
Name: DR.
JAMES
CARLTON
HUTTON
Title or Position: OWNER PRESIDENT
Credential: DC
Phone: 540-364-2045