Provider Demographics
NPI:1538671037
Name:ACTIVE HEALTH CHIROPRACTIC, PLC
Entity Type:Organization
Organization Name:ACTIVE HEALTH CHIROPRACTIC, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BROOKE
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-868-9969
Mailing Address - Street 1:201 CENTRE DR STE 102
Mailing Address - Street 2:
Mailing Address - City:STEPHENS CITY
Mailing Address - State:VA
Mailing Address - Zip Code:22655-4073
Mailing Address - Country:US
Mailing Address - Phone:540-868-9969
Mailing Address - Fax:540-868-9968
Practice Address - Street 1:201 CENTRE DR STE 102
Practice Address - Street 2:
Practice Address - City:STEPHENS CITY
Practice Address - State:VA
Practice Address - Zip Code:22655-4073
Practice Address - Country:US
Practice Address - Phone:540-868-9969
Practice Address - Fax:540-868-9968
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-25
Last Update Date:2017-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty