Provider Demographics
NPI:1144389198
Name:HAMPTON ROADS CHIROPRACTIC P.C.
Entity Type:Organization
Organization Name:HAMPTON ROADS CHIROPRACTIC P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIRORACTOR
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:E
Authorized Official - Last Name:OLNEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:757-596-9696
Mailing Address - Street 1:1056 HARPERSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23601-1010
Mailing Address - Country:US
Mailing Address - Phone:757-596-9696
Mailing Address - Fax:757-595-4742
Practice Address - Street 1:1056 HARPERSVILLE RD
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23601-1010
Practice Address - Country:US
Practice Address - Phone:757-596-9696
Practice Address - Fax:757-595-4742
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2010-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA598111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA350000508Medicare ID - Type Unspecified