Healthcare Provider Details

I. General information

NPI: 1679626402
Provider Name (Legal Business Name): ADJUSTMENTS FOR LIFE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 08/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

727 LAKE MONTICELLO RD UNIT A
PALMYRA VA
22963-4236
US

IV. Provider business mailing address

727 LAKE MONTICELLO RD UNIT A
PALMYRA VA
22963-4236
US

V. Phone/Fax

Practice location:
  • Phone: 434-589-5433
  • Fax: 434-589-5433
Mailing address:
  • Phone: 434-589-5433
  • Fax: 434-591-0010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number0104556160
License Number StateVA

VIII. Authorized Official

Name: DR. ROBERT ALAN BURGER JR.
Title or Position: OWNER
Credential: D.C.
Phone: 434-589-5433