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General NPI Number Information
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NPI Number | 1639221500
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Entity Type | Organization
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Legal Business Name | RICHMOND CHIROPRACTIC, INC.
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Dates
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Enumeration Date | 01/18/2007
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Last Update Date | 02/27/2019
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Provider Practice Location Address
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Address Line | 535 SOUTHLAKE BLVD
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23236-3042
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Country | US
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Telephone | 804-897-6130
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Fax | 804-924-2168
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Provider Business Mailing Address
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Address Line | 535 SOUTHLAKE BLVD
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23236-3042
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Country | US
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Telephone | 804-897-6130
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Fax | 804-924-2168
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Authorized Official
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Title or Position | OWNER
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Name | DOUGLAS F AMBROSE
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Credential | DC, FIAMA
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Telephone | 804-897-6130
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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 | 0104001902
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License Number State | VA
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