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General NPI Number Information
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NPI Number | 1831694405
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Entity Type | Organization
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Legal Business Name | BEDFORD CHIROPRACTIC CLINIC PC
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Dates
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Enumeration Date | 03/27/2018
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Last Update Date | 04/25/2018
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Provider Practice Location Address
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Address Line | 1029 TURNPIKE RD STE C
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City | BEDFORD
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State | VA
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Zip | 24523-1811
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Country | US
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Telephone | 540-586-5860
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Fax | 540-586-4930
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Provider Business Mailing Address
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Address Line | 1029 TURNPIKE RD STE C
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City | BEDFORD
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State | VA
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Zip | 24523-1811
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Country | US
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Telephone | 540-586-5860
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Fax | 540-586-4930
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | LINDA MARIA SELANDER
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Credential | C.A.
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Telephone | 540-586-5860
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 0104557198
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License Number State | VA
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