Provider Demographics
NPI:1073600201
Name:GFC MANAGEMENT GROUP
Entity Type:Organization
Organization Name:GFC MANAGEMENT GROUP
Other - Org Name:GREENBRIER FAMILY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:TRUSTEE
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:E
Authorized Official - Last Name:TRUDEAU
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:757-436-6677
Mailing Address - Street 1:801 VOLVO PKWY
Mailing Address - Street 2:STE 118
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-2811
Mailing Address - Country:US
Mailing Address - Phone:757-436-6677
Mailing Address - Fax:757-436-6789
Practice Address - Street 1:801 VOLVO PKWY
Practice Address - Street 2:STE 118
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-2811
Practice Address - Country:US
Practice Address - Phone:757-436-6677
Practice Address - Fax:757-436-6789
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA073643OtherANTHEMBCBS, GROUP #
VA073645OtherANTHEMBCBS,DR. JIM, IND#
VA073646OtherANTHEMBCBS,DR. JULIA,IND#
VAC03579Medicare ID - Type UnspecifiedGROUP#
VA073643OtherANTHEMBCBS, GROUP #
VAU41631Medicare UPIN