Provider Demographics
NPI:1154326643
Name:MORENINGS, IMANUEL (DC)
Entity Type:Individual
Prefix:DR
First Name:IMANUEL
Middle Name:
Last Name:MORENINGS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2022 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:VA
Mailing Address - Zip Code:24201-3610
Mailing Address - Country:US
Mailing Address - Phone:276-466-3012
Mailing Address - Fax:276-466-1502
Practice Address - Street 1:2022 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:VA
Practice Address - Zip Code:24201-3610
Practice Address - Country:US
Practice Address - Phone:276-466-3012
Practice Address - Fax:276-466-1502
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2010-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104000510111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAVA0102OtherJOHN DEERE
TN0124256Medicaid
VA3500014411OtherRAILROAD MEDICARE
VA1281720001OtherADMINASTAR
VA058407OtherANTHEM B/C B/S #
VA295687100OtherUS DEPARTMENT OF LABOR #
VA8930236Medicaid
VA3500014411OtherRAILROAD MEDICARE
VA8930236Medicaid