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NPI Code Detail

MEDICARE: DR. ELLIOT STUART EISENBERG DC

MEDICARE:  DR. ELLIOT STUART EISENBERG  DC
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
1111N00000XChiropractor0104000355VA

General Provider Information

NPI Number : 1720026404
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ELLIOT STUART EISENBERG DC
Provider Business Mailing Address
First Line : 3904 MEADOWDALE BLVD
Second Line :
City : RICHMOND
State : VA
Zip : 23234
Country : US
Telephone Number : 804-271-7920
Fax Number : 804-271-8538
Provider Business Practice Location Address
First Line : 3904 MEADOWDALE BLVD
Second Line :
City : RICHMOND
State : VA
Zip : 23234
Country : US
Telephone Number : 804-271-7920
Fax Number : 804-271-8538
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2006
Last Update Date : 07/08/2007

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Directions to “ DR. ELLIOT STUART EISENBERG DC” Practice Location

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