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General NPI Number Information
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NPI Number | 1457725376
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Entity Type | Organization
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Legal Business Name | RED MILL CHIROPRACTIC LLC
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Dates
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Enumeration Date | 11/16/2015
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Last Update Date | 12/27/2019
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Provider Practice Location Address
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Address Line | 2236 GENERAL BOOTH BLVD
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City | VIRGINIA BEACH
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State | VA
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Zip | 23456-4092
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Country | US
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Telephone | 757-467-5258
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Fax |
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Provider Business Mailing Address
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Address Line | 2236 GENERAL BOOTH BLVD SUITE 110
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City | VIRGINIA BEACH
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State | VA
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Zip | 23456-4092
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Country | US
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Telephone | 757-467-5258
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Fax | 757-467-4641
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Authorized Official
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Title or Position | BILLING LEAD/ADMIN ASSISTANT
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Name | KELLI PIERCE
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Credential |
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Telephone | 757-467-5258
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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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