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General NPI Number Information
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NPI Number | 1093909715
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Entity Type | Organization
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Legal Business Name | ERICA L POLLACK
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Dates
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Enumeration Date | 09/06/2007
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Last Update Date | 06/16/2010
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Provider Practice Location Address
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Address Line | 3609 BLUE RIDGE BLVD
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City | BLUE RIDGE
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State | VA
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Zip | 24064-1976
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Country | US
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Telephone | 540-977-4611
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Fax | 540-977-4611
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Provider Business Mailing Address
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Address Line | PO BOX 4127
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City | ROANOKE
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State | VA
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Zip | 24015-0127
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Country | US
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Telephone | 540-981-9394
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Fax | 540-344-7154
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | ERICA L POLLACK
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Credential | DC
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Telephone | 540-977-4611
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 0104001490
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License Number State | VA
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