Healthcare Provider Details

I. General information

NPI: 1134123482
Provider Name (Legal Business Name): STEWART MELVILLE RAWNSLEY D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2005
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

514 MAIN ST
NARROWS VA
24124-1321
US

IV. Provider business mailing address

514 MAIN ST
NARROWS VA
24124-1321
US

V. Phone/Fax

Practice location:
  • Phone: 540-726-2318
  • Fax: 540-726-7665
Mailing address:
  • Phone: 540-726-2318
  • Fax: 540-726-7665

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number0104000570
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3806
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number514
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: