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General NPI Number Information
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NPI Number | 1215324082
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Entity Type | Organization
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Legal Business Name | DOGWOOD CHIROPRACTIC AND WELLNESS
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Dates
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Enumeration Date | 04/20/2015
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Last Update Date | 04/21/2015
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Provider Practice Location Address
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Address Line | 1710 ALLIED ST SUITE 20 B
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22903-5334
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Country | US
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Telephone | 434-218-2466
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Fax |
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Provider Business Mailing Address
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Address Line | 2921 BROOKMERE RD
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22901-1110
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DOCTOR OF CHIROPRACTIC
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Name | ALICIA HAMILTON
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Credential | D.C.
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Telephone | 330-671-9939
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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 | 0104557063
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License Number State | VA
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