MEDICARE: ABC CHIROPRACTIC INC

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	0104001033	VA

General Provider Information

NPI Number	:	1578733085
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABC CHIROPRACTIC INC

Provider Business Mailing Address
First Line	:	2654 VALLEY AVE
Second Line	:	SUITE E
City	:	WINCHESTER
State	:	VA
Zip	:	22601-2661
Country	:	US
Telephone Number	:	540-678-0100
Fax Number	:	540-678-1396

Provider Business Practice Location Address
First Line	:	2654 VALLEY AVE
Second Line	:	SUITE E
City	:	WINCHESTER
State	:	VA
Zip	:	22601-2661
Country	:	US
Telephone Number	:	540-678-0100
Fax Number	:	540-678-1396

Authorized Official
Title or Position	:	OWNER/ PRESIDENT
Name	:	MEREDITH L OUDT
Credential	:	DC
Telephone Number	:	540-678-0100

Provider Enumeration Date	:	03/11/2008
Last Update Date	:	04/12/2011

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Directions to “ABC CHIROPRACTIC INC ” Practice Location

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