Provider Demographics
NPI:1306029657
Name:TOWNE & COUNTRY CHIROPRACTIC, LTD
Entity Type:Organization
Organization Name:TOWNE & COUNTRY CHIROPRACTIC, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LAYTON
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:MERITHEW
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:804-693-0093
Mailing Address - Street 1:6091 GEORGE WASHINGTON MEMORIAL HWY
Mailing Address - Street 2:
Mailing Address - City:GLOUCESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23061-3750
Mailing Address - Country:US
Mailing Address - Phone:804-693-0093
Mailing Address - Fax:804-693-6311
Practice Address - Street 1:6091 GEORGE WASHINGTON MEMORIAL HWY
Practice Address - Street 2:
Practice Address - City:GLOUCESTER
Practice Address - State:VA
Practice Address - Zip Code:23061-3750
Practice Address - Country:US
Practice Address - Phone:804-693-0093
Practice Address - Fax:804-693-6311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-10
Last Update Date:2010-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104000677111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA67621OtherCIGNA
VA051286OtherANTHEM
VA89-1459-1Medicaid
VALM460091OtherANTHEM HEALTHKEEPERS
VAC08291Medicare PIN
VA89-1459-1Medicaid