Provider Demographics
NPI:1376551176
Name:THESIER CHIROPRACTIC CLINIC, P.C.
Entity Type:Organization
Organization Name:THESIER CHIROPRACTIC CLINIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:R
Authorized Official - Last Name:THESIER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:757-486-3222
Mailing Address - Street 1:240 MUSTANG TRL
Mailing Address - Street 2:SUITE 3
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-7516
Mailing Address - Country:US
Mailing Address - Phone:757-486-3222
Mailing Address - Fax:
Practice Address - Street 1:240 MUSTANG TRL
Practice Address - Street 2:SUITE 3
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-7516
Practice Address - Country:US
Practice Address - Phone:757-486-3222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104000339111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAT-215-27Medicare UPIN