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NPI 1821157330

NPI 1821157330 : CHRISTINE LEIGH FALLWELL D.C. : VIRGINIA BEACH, VA

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General NPI Number Information
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    NPI Number           |    1821157330
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    Entity Type          |    Individual 
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    Provider Name        |    CHRISTINE LEIGH FALLWELL D.C.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    12/08/2006
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    Last Update Date     |    03/30/2022
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Provider Practice Location Address
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    Address Line         |    325 FIRST COLONIAL RD STE D 
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    City                 |    VIRGINIA BEACH
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    State                |    VA
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    Zip                  |    23454-4665
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    Country              |    US
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    Telephone            |    757-498-8700
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1067 TOTTENHAM LN 
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    City                 |    VIRGINIA BEACH
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    State                |    VA
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    Zip                  |    23454-3153
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    Country              |    US
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    Telephone            |    757-498-8700
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    Fax                  |    757-498-8764
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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       |    0104555854
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    License Number State |    VA
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