Provider Demographics
NPI:1235602426
Name:COURTHOUSE CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:COURTHOUSE CHIROPRACTIC, LLC
Other - Org Name:CHIROPRACTIC CARE OF HAYES, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:TISO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:804-684-5196
Mailing Address - Street 1:3073 GEORGE WASHINGTON MEMORIAL HWY
Mailing Address - Street 2:
Mailing Address - City:HAYES
Mailing Address - State:VA
Mailing Address - Zip Code:23072-3300
Mailing Address - Country:US
Mailing Address - Phone:804-684-5196
Mailing Address - Fax:
Practice Address - Street 1:3073 GEORGE WASHINGTON MEMORIAL HWY
Practice Address - Street 2:
Practice Address - City:HAYES
Practice Address - State:VA
Practice Address - Zip Code:23072-3300
Practice Address - Country:US
Practice Address - Phone:757-202-2960
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-10
Last Update Date:2019-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty