Provider Demographics
NPI:1477747558
Name:KEYSVILLE CHIROPRACTIC PLC
Entity Type:Organization
Organization Name:KEYSVILLE CHIROPRACTIC PLC
Other - Org Name:COMMUNITY CHIROPRACTIC, PLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:M
Authorized Official - Last Name:SCHRIER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:434-315-5868
Mailing Address - Street 1:PO BOX 136
Mailing Address - Street 2:
Mailing Address - City:KEYSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23947-0136
Mailing Address - Country:US
Mailing Address - Phone:434-315-5868
Mailing Address - Fax:434-315-5989
Practice Address - Street 1:176 KING STREET
Practice Address - Street 2:
Practice Address - City:KEYSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23947-5103
Practice Address - Country:US
Practice Address - Phone:434-736-9895
Practice Address - Fax:434-736-9897
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-30
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104556537111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC10420Medicare PIN