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General NPI Number Information
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NPI Number | 1144409772
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Entity Type | Organization
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Legal Business Name | CONOVER CHIROPRACTIC CENTER INC.
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Dates
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Enumeration Date | 10/31/2007
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Last Update Date | 04/17/2018
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Provider Practice Location Address
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Address Line | 11015 WARWICK BLVD STE 100
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City | NEWPORT NEWS
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State | VA
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Zip | 23601-3225
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Country | US
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Telephone | 757-591-8834
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Fax | 757-591-2542
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Provider Business Mailing Address
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Address Line | 9610 WARWICK BLVD
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City | NEWPORT NEWS
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State | VA
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Zip | 23601-4541
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Country | US
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Telephone | 757-591-8834
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Fax | 757-591-2542
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | DR. KEVIN L CONOVER
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Credential | D.C.
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Telephone | 757-591-8834
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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 | 0104001663
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License Number State | VA
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