Provider Demographics
NPI:1114919446
Name:MLPA INC
Entity Type:Organization
Organization Name:MLPA INC
Other - Org Name:FAMILY CHIROPRACTIC CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:PASTERNACK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:540-545-7891
Mailing Address - Street 1:609 CEDAR CREEK GRADE
Mailing Address - Street 2:SUITE B
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-2721
Mailing Address - Country:US
Mailing Address - Phone:540-545-7891
Mailing Address - Fax:540-545-7893
Practice Address - Street 1:609 CEDAR CREEK GRADE
Practice Address - Street 2:SUITE B
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-2721
Practice Address - Country:US
Practice Address - Phone:540-545-7891
Practice Address - Fax:540-545-7893
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-23
Last Update Date:2009-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1035111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
203358OtherANTHEM BCBS
203358OtherANTHEM BCBS