Provider Demographics
NPI:1568882892
Name:ISLAND OASIS CHIROPRACTIC, P.L.L.C.
Entity Type:Organization
Organization Name:ISLAND OASIS CHIROPRACTIC, P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:COCHRAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:757-333-0368
Mailing Address - Street 1:620 VILLAGE DR
Mailing Address - Street 2:STE. A
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-4276
Mailing Address - Country:US
Mailing Address - Phone:757-333-0368
Mailing Address - Fax:703-649-6416
Practice Address - Street 1:620 VILLAGE DR
Practice Address - Street 2:STE. A
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-4276
Practice Address - Country:US
Practice Address - Phone:757-333-0368
Practice Address - Fax:703-649-6416
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-25
Last Update Date:2014-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104557172111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty