Provider Demographics
NPI:1083944250
Name:HEALTH FIRST CHIROPRACTIC, INC
Entity Type:Organization
Organization Name:HEALTH FIRST CHIROPRACTIC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHERINE
Authorized Official - Middle Name:MARY
Authorized Official - Last Name:VANWAGNER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:804-270-6010
Mailing Address - Street 1:11355 NUCKOLS RD
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23059-5504
Mailing Address - Country:US
Mailing Address - Phone:804-270-6010
Mailing Address - Fax:804-270-6551
Practice Address - Street 1:11520 NUCKOLS RD STE 101
Practice Address - Street 2:
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23059-2558
Practice Address - Country:US
Practice Address - Phone:804-564-6120
Practice Address - Fax:804-270-6551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-11
Last Update Date:2021-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104555873111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA350001141Medicare UPIN