Healthcare Provider Details

I. General information

NPI: 1356334908
Provider Name (Legal Business Name): JAMIE L . HIGLEY D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2005
Last Update Date: 07/28/2010
Certification Date:
Deactivation Date: 03/23/2006
Reactivation Date: 03/29/2006

III. Provider practice location address

3430 ANDERSON HWY SUITE C
POWHATAN VA
23139-5834
US

IV. Provider business mailing address

3430 ANDERSON HWY SUITE C
POWHATAN VA
23139-5834
US

V. Phone/Fax

Practice location:
  • Phone: 804-598-6300
  • Fax: 804-598-8755
Mailing address:
  • Phone: 804-598-6300
  • Fax: 804-598-8755

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number0104001731
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: