Provider Demographics
NPI:1336132299
Name:MLPA INC
Entity Type:Organization
Organization Name:MLPA INC
Other - Org Name:FAMILY CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:PASTERNACK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:540-635-1270
Mailing Address - Street 1:29 CRESCENT ST
Mailing Address - Street 2:
Mailing Address - City:FRONT ROYAL
Mailing Address - State:VA
Mailing Address - Zip Code:22630-3328
Mailing Address - Country:US
Mailing Address - Phone:540-635-1270
Mailing Address - Fax:540-635-2732
Practice Address - Street 1:29 CRESCENT ST
Practice Address - Street 2:
Practice Address - City:FRONT ROYAL
Practice Address - State:VA
Practice Address - Zip Code:22630-3328
Practice Address - Country:US
Practice Address - Phone:540-635-1270
Practice Address - Fax:540-635-2732
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1035111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA202381OtherANTHEM BCBS