Provider Demographics
NPI:1003681842
Name:HEALING PATH CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:HEALING PATH CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:
Authorized Official - First Name:TYLER
Authorized Official - Middle Name:
Authorized Official - Last Name:RANDOLPH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:540-836-8416
Mailing Address - Street 1:520 LEW DEWITT BLVD STE 402
Mailing Address - Street 2:
Mailing Address - City:WAYNESBORO
Mailing Address - State:VA
Mailing Address - Zip Code:22980-1644
Mailing Address - Country:US
Mailing Address - Phone:540-943-3638
Mailing Address - Fax:
Practice Address - Street 1:520 LEW DEWITT BLVD STE 402
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:VA
Practice Address - Zip Code:22980-1644
Practice Address - Country:US
Practice Address - Phone:540-943-3638
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-21
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty