Provider Demographics
NPI:1275726440
Name:TRUE HEALTH CHIROPRACTIC INC
Entity Type:Organization
Organization Name:TRUE HEALTH CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:BRYCEN
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:HUDOCK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:434-975-6100
Mailing Address - Street 1:355 RIO RD W STE 106
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22901-1360
Mailing Address - Country:US
Mailing Address - Phone:434-975-6100
Mailing Address - Fax:
Practice Address - Street 1:355 RIO RD W STE 106
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901-1360
Practice Address - Country:US
Practice Address - Phone:434-975-6100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-21
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104555887111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC09715OtherMEDICARE GROUP NUMBER
VA00W890T01Medicare PIN
VAU84748Medicare UPIN