Provider Demographics
NPI:1477986800
Name:VALLEY FAMILY WELLNESS AND CHIROPRACTIC
Entity Type:Organization
Organization Name:VALLEY FAMILY WELLNESS AND CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:D
Authorized Official - Last Name:DODGE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:540-885-1735
Mailing Address - Street 1:1600 N COALTER ST
Mailing Address - Street 2:SUITE 303A
Mailing Address - City:STAUNTON
Mailing Address - State:VA
Mailing Address - Zip Code:24401-2551
Mailing Address - Country:US
Mailing Address - Phone:540-885-1735
Mailing Address - Fax:540-885-1736
Practice Address - Street 1:1600 N COALTER ST
Practice Address - Street 2:SUITE 303A
Practice Address - City:STAUNTON
Practice Address - State:VA
Practice Address - Zip Code:24401-2551
Practice Address - Country:US
Practice Address - Phone:540-885-1735
Practice Address - Fax:540-885-1736
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-21
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104556995261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service