MEDICARE: DR. CHRISTINE LEIGH FALLWELL D.C.

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	0104555854	VA

General Provider Information

NPI Number	:	1821157330
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTINE LEIGH FALLWELL D.C.

Provider Business Mailing Address
First Line	:	1067 TOTTENHAM LN
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23454-3153
Country	:	US
Telephone Number	:	757-498-8700
Fax Number	:	757-498-8764

Provider Business Practice Location Address
First Line	:	325 FIRST COLONIAL RD STE D
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23454-4665
Country	:	US
Telephone Number	:	757-498-8700
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/08/2006
Last Update Date	:	03/30/2022

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