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NPI Code Detail

MEDICARE: QUINTESSENTIAL CHIROPRACTIC, LLC

MEDICARE: QUINTESSENTIAL 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
1261Q00000XClinic/Center0104556826VA

General Provider Information

NPI Number : 1528372885
Entity Type Code : Organization
Provider Name (Legal Business Name) : QUINTESSENTIAL CHIROPRACTIC, LLC
Provider Business Mailing Address
First Line : 16021 KAIROS RD
Second Line : SUITE C
City : SOUTH CHESTERFIELD
State : VA
Zip : 23834-5205
Country : US
Telephone Number : 804-536-6262
Fax Number :
Provider Business Practice Location Address
First Line : 16021 KAIROS RD
Second Line : SUITE C
City : SOUTH CHESTERFIELD
State : VA
Zip : 23834-5205
Country : US
Telephone Number : 804-536-6262
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DR. KATRINA S MAYES
Credential : D.C.
Telephone Number : 804-536-6262
Provider Enumeration Date : 07/28/2010
Last Update Date : 10/12/2016

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Directions to “QUINTESSENTIAL CHIROPRACTIC, LLC ” Practice Location

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