Provider Demographics
NPI:1346201282
Name:LOMBARDOZZI, ANDREW (DC)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:LOMBARDOZZI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1125 GASKINS RD STE 400
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23238-5200
Mailing Address - Country:US
Mailing Address - Phone:804-740-3434
Mailing Address - Fax:804-747-8702
Practice Address - Street 1:1125 GASKINS RD STE 400
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23238-5200
Practice Address - Country:US
Practice Address - Phone:804-740-3434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-30
Last Update Date:2019-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104556290111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA176689OtherANTHEM BCBS
VA672753OtherSOUTHERN HEALTH SVCS
VA1649390253Medicaid