Provider Demographics
NPI:1235307950
Name:CREEKSIDE CHIROPRACTIC, P.C.
Entity Type:Organization
Organization Name:CREEKSIDE CHIROPRACTIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:UBERT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:540-662-6284
Mailing Address - Street 1:3119 VALLEY AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-2665
Mailing Address - Country:US
Mailing Address - Phone:540-662-6284
Mailing Address - Fax:
Practice Address - Street 1:3119 VALLEY AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-2665
Practice Address - Country:US
Practice Address - Phone:540-662-6284
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-15
Last Update Date:2010-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104002027111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty