Healthcare Provider Details

I. General information

NPI: 1841347903
Provider Name (Legal Business Name): ACCIDENT & INJURY CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1712 AIRLINE BLVD
PORTSMOUTH VA
23707-3911
US

IV. Provider business mailing address

1712 AIRLINE BLVD
PORTSMOUTH VA
23707-3911
US

V. Phone/Fax

Practice location:
  • Phone: 757-295-4950
  • Fax:
Mailing address:
  • Phone: 757-295-4950
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number0104001311
License Number StateVA

VIII. Authorized Official

Name: MATHEW HILL
Title or Position: PRESIDENT
Credential:
Phone: 276-632-3334