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General NPI Number Information
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NPI Number | 1528109543
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Entity Type | Organization
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Legal Business Name | CHIROPRATIC WELLNESS CENTER INC
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Dates
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Enumeration Date | 02/11/2007
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Last Update Date | 03/21/2012
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Provider Practice Location Address
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Address Line | 601 N COURTHOUSE RD
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City | RICHMOND
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State | VA
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Zip | 23236-4062
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Country | US
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Telephone | 804-378-9355
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Fax | 804-794-9751
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Provider Business Mailing Address
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Address Line | 601 N COURTHOUSE RD
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23236-4062
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Country | US
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Telephone | 804-378-9355
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Fax | 804-794-9751
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RICHARD DENNIS RANALLO
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Credential | D.C.
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Telephone | 804-378-9355
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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 | 0000479
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License Number State | VA
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