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General NPI Number Information
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NPI Number | 1952479727
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Entity Type | Organization
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Legal Business Name | CHIROPRACTIC INITIATIVES, INC
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Dates
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Enumeration Date | 12/01/2006
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Last Update Date | 03/22/2018
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Provider Practice Location Address
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Address Line | 2004 BREMO RD STE 101
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City | RICHMOND
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State | VA
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Zip | 23226-2442
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Country | US
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Telephone | 804-288-0582
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Fax | 804-977-1301
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Provider Business Mailing Address
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Address Line | 2901 STONEWALL AVE
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City | RICHMOND
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State | VA
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Zip | 23225-3554
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Country | US
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Telephone | 804-814-3545
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | NELSON FISHER GREGORY
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Credential | DC
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Telephone | 804-814-3545
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | 0104000707
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License Number State | VA
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