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General NPI Number Information
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NPI Number | 1700074028
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Entity Type | Organization
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Legal Business Name | FAMILY FIRST CHIROPRACTIC
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Dates
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Enumeration Date | 10/11/2007
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Last Update Date | 11/28/2011
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Provider Practice Location Address
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Address Line | 2696 WHITE HALL BLVD
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City | FAIRMONT
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State | WV
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Zip | 26554-8226
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Country | US
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Telephone | 304-333-6668
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Fax | 304-333-6666
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Provider Business Mailing Address
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Address Line | 2696 WHITE HALL BLVD
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City | FAIRMONT
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State | WV
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Zip | 26554-8226
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Country | US
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Telephone | 304-333-6668
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Fax | 304-333-6666
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Authorized Official
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Title or Position | CHIROPRACTOR/OWNER
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Name | DR. BRIAN R MENZIES
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Credential | D.C.
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Telephone | 304-333-6668
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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 | 833
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License Number State | WV
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