Provider Demographics
NPI:1376961003
Name:SHENANDOAH SPINECARE, PLLC.
Entity Type:Organization
Organization Name:SHENANDOAH SPINECARE, PLLC.
Other - Org Name:SHENANDOAH SPINECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:DOREY
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:434-249-6333
Mailing Address - Street 1:905 CEDAR CREEK GRADE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-7100
Mailing Address - Country:US
Mailing Address - Phone:434-249-6333
Mailing Address - Fax:
Practice Address - Street 1:905 CEDAR CREEK GRADE
Practice Address - Street 2:SUITE 102
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-7100
Practice Address - Country:US
Practice Address - Phone:434-249-6333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-31
Last Update Date:2014-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104-556624111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty