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General NPI Number Information
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NPI Number | 1710257506
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Entity Type | Individual
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Provider Name | JARED HEATH FIEDLER D.C.
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Gender | Male
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Dates
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Enumeration Date | 01/10/2012
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Last Update Date | 03/04/2015
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Provider Practice Location Address
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Address Line | 1920 CENTERVILLE TPKE SUITE 95
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City | VIRGINIA BEACH
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State | VA
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Zip | 23464-6800
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Country | US
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Telephone | 610-996-3433
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Fax |
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Provider Business Mailing Address
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Address Line | 1335 FISHERMANS RD
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City | NORFOLK
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State | VA
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Zip | 23503-4037
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Country | US
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Telephone | 610-996-3433
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | DC010602
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 0104557100
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License Number State | VA
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