Provider Demographics
NPI:1174682496
Name:YORK COUNTY CHIROPRACTIC
Entity Type:Organization
Organization Name:YORK COUNTY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DUANE
Authorized Official - Middle Name:H
Authorized Official - Last Name:CONNELL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:757-989-5393
Mailing Address - Street 1:121 GRAFTON STATION LN
Mailing Address - Street 2:SUITE G
Mailing Address - City:YORKTOWN
Mailing Address - State:VA
Mailing Address - Zip Code:23692-4776
Mailing Address - Country:US
Mailing Address - Phone:757-989-5393
Mailing Address - Fax:757-989-0551
Practice Address - Street 1:121 GRAFTON STATION LN
Practice Address - Street 2:SUITE G
Practice Address - City:YORKTOWN
Practice Address - State:VA
Practice Address - Zip Code:23692-4776
Practice Address - Country:US
Practice Address - Phone:757-989-5393
Practice Address - Fax:757-989-0551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104001296111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA331890OtherBCBS PIN
VA331889OtherBCBS GROUP PIN
VA331890OtherBCBS PIN