Provider Demographics
NPI:1093080400
Name:ROCKINGHAM CHIROPRACTIC
Entity Type:Organization
Organization Name:ROCKINGHAM CHIROPRACTIC
Other - Org Name:ROCKIGHAM CHIROPRACTIC PLLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GABRIEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:540-437-2322
Mailing Address - Street 1:1589 PORT REPUBLIC RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-3517
Mailing Address - Country:US
Mailing Address - Phone:540-437-2322
Mailing Address - Fax:540-437-2321
Practice Address - Street 1:1589 PORT REPUBLIC RD
Practice Address - Street 2:SUITE 1
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-3517
Practice Address - Country:US
Practice Address - Phone:540-437-2322
Practice Address - Fax:540-437-2321
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-19
Last Update Date:2012-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104556863111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty