Provider Demographics
NPI:1497910269
Name:PRECISION SPINAL CARE, INC.
Entity Type:Organization
Organization Name:PRECISION SPINAL CARE, INC.
Other - Org Name:PRECISION SPINAL CARE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ASSOCIATE DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:DAYTON
Authorized Official - Last Name:HARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:757-382-5555
Mailing Address - Street 1:1305 EXECUTIVE BLVD
Mailing Address - Street 2:SUITE 170
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-3676
Mailing Address - Country:US
Mailing Address - Phone:757-382-5555
Mailing Address - Fax:757-382-5556
Practice Address - Street 1:1305 EXECUTIVE BLVD
Practice Address - Street 2:SUITE 170
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-3676
Practice Address - Country:US
Practice Address - Phone:757-382-5555
Practice Address - Fax:757-382-5556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-22
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104556541111N00000X
VA0104556052111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty