Provider Demographics
NPI:1326082553
Name:BACH, JEFFREY ALAN (D C)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:ALAN
Last Name:BACH
Suffix:
Gender:M
Credentials:D C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 FALL HILL AVE
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-3345
Mailing Address - Country:US
Mailing Address - Phone:540-374-0998
Mailing Address - Fax:540-371-0378
Practice Address - Street 1:2501 FALL HILL AVE
Practice Address - Street 2:STE B
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-3345
Practice Address - Country:US
Practice Address - Phone:540-374-0998
Practice Address - Fax:540-371-0378
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-16
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104001504111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor