Provider Demographics
NPI:1346564499
Name:HANDLY CHIROPRACTIC & WELLNESS CENTER LLC
Entity Type:Organization
Organization Name:HANDLY CHIROPRACTIC & WELLNESS CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DON
Authorized Official - Middle Name:TYLER
Authorized Official - Last Name:HANDLY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:276-647-3728
Mailing Address - Street 1:4848 KINGS MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:COLLINSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24078-1275
Mailing Address - Country:US
Mailing Address - Phone:276-647-3728
Mailing Address - Fax:276-622-2003
Practice Address - Street 1:4848 KINGS MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:COLLINSVILLE
Practice Address - State:VA
Practice Address - Zip Code:24078-1275
Practice Address - Country:US
Practice Address - Phone:276-647-3728
Practice Address - Fax:276-662-2003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-18
Last Update Date:2021-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104001795111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty