Healthcare Provider Details

I. General information

NPI: 1033451273
Provider Name (Legal Business Name): METHENY CHIROPRACTIC CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2013
Last Update Date: 03/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

64 TANAGER DR
OLD FIELDS WV
26845-8621
US

IV. Provider business mailing address

PO BOX 178
MOOREFIELD WV
26836-0178
US

V. Phone/Fax

Practice location:
  • Phone: 304-703-3737
  • Fax:
Mailing address:
  • Phone: 304-703-3737
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. JACOB METHENY
Title or Position: OWNER/CHIROPRACTOR
Credential:
Phone: 304-703-3737