MEDICARE: BLUE RIDGE CLINIC OF CHIROPRACTIC, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	0104002062	VA

General Provider Information

NPI Number	:	1417235409
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLUE RIDGE CLINIC OF CHIROPRACTIC, LLC

Provider Business Mailing Address
First Line	:	PO BOX 641
Second Line	:
City	:	STUARTS DRAFT
State	:	VA
Zip	:	24477-0641
Country	:	US
Telephone Number	:	540-337-1238
Fax Number	:

Provider Business Practice Location Address
First Line	:	2780 STUARTS DRAFT HWY
Second Line	:	SUITE #106
City	:	STUARTS DRAFT
State	:	VA
Zip	:	24477-2779
Country	:	US
Telephone Number	:	540-337-1238
Fax Number	:	540-338-1239

Authorized Official
Title or Position	:	CHIROPRACTOR/SOLE MEMBER
Name	:	DR. DAVID T. ROBINSON
Credential	:	D.C.
Telephone Number	:	540-337-1238

Provider Enumeration Date	:	07/26/2011
Last Update Date	:	04/08/2025

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24 GLOUCESTER RD
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