Provider Demographics
NPI:1497210413
Name:INFINITY CHIROPRACTIC OF GLOUCESTER
Entity Type:Organization
Organization Name:INFINITY CHIROPRACTIC OF GLOUCESTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEEK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:757-753-4700
Mailing Address - Street 1:202 FIELDING LEWIS DR
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN
Mailing Address - State:VA
Mailing Address - Zip Code:23692-2808
Mailing Address - Country:US
Mailing Address - Phone:757-753-4700
Mailing Address - Fax:
Practice Address - Street 1:2654 GEORGE WASHINGTON MEMORIAL HWY
Practice Address - Street 2:
Practice Address - City:HAYES
Practice Address - State:VA
Practice Address - Zip Code:23072-3464
Practice Address - Country:US
Practice Address - Phone:804-642-6106
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-04
Last Update Date:2019-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty