Provider Demographics
NPI:1467880674
Name:MACDONALD CHIROPRACTIC PC
Entity Type:Organization
Organization Name:MACDONALD CHIROPRACTIC PC
Other - Org Name:WOODSTOCK CHIROPRACTIC & ACUPUNCTURE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:CULLY
Authorized Official - Last Name:MACDONALD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:540-459-4727
Mailing Address - Street 1:712B N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:VA
Mailing Address - Zip Code:22664-1816
Mailing Address - Country:US
Mailing Address - Phone:540-459-4727
Mailing Address - Fax:540-459-7989
Practice Address - Street 1:712B N MAIN ST
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:VA
Practice Address - Zip Code:22664-1816
Practice Address - Country:US
Practice Address - Phone:540-459-4727
Practice Address - Fax:540-459-7989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-25
Last Update Date:2015-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104556627111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty