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General NPI Number Information
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NPI Number | 1437570389
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Entity Type | Organization
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Legal Business Name | COLONIAL HEIGHTS CHIROPRACTIC AND WELLNESS CENTER, INC.
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Dates
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Enumeration Date | 12/19/2013
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Last Update Date | 12/19/2013
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Provider Practice Location Address
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Address Line | 209 TEMPLE AVE
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City | COLONIAL HEIGHTS
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State | VA
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Zip | 23834-2827
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Country | US
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Telephone | 804-523-8014
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Fax |
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Provider Business Mailing Address
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Address Line | 209 TEMPLE AVE
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City | COLONIAL HEIGHTS
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State | VA
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Zip | 23834-2827
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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 | PRESIDENT
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Name | DR. JOSEPH S KENNEDY
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Credential | DC
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Telephone | 804-523-8014
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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 |
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License Number State |
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