Provider Demographics
NPI:1508086307
Name:CHIROCARE, INC
Entity Type:Organization
Organization Name:CHIROCARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:BAUER
Authorized Official - Last Name:GARST
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:540-297-3440
Mailing Address - Street 1:16483 MONETA RD STE I
Mailing Address - Street 2:
Mailing Address - City:MONETA
Mailing Address - State:VA
Mailing Address - Zip Code:24121-5756
Mailing Address - Country:US
Mailing Address - Phone:540-297-3440
Mailing Address - Fax:
Practice Address - Street 1:16483 MONETA RD STE I
Practice Address - Street 2:
Practice Address - City:MONETA
Practice Address - State:VA
Practice Address - Zip Code:24121-5756
Practice Address - Country:US
Practice Address - Phone:540-297-3440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104000405111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC09282Medicare ID - Type UnspecifiedCHIROCARE'S PROVIDER #