Provider Demographics
NPI:1598996670
Name:BRISCOE, MEGGEN M (DC)
Entity Type:Individual
Prefix:DR
First Name:MEGGEN
Middle Name:M
Last Name:BRISCOE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 OLDE GREENWICH DR
Mailing Address - Street 2:SUITE 175
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22408-4001
Mailing Address - Country:US
Mailing Address - Phone:540-656-2885
Mailing Address - Fax:
Practice Address - Street 1:125 OLDE GREENWICH DR
Practice Address - Street 2:SUITE 175
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22408-4001
Practice Address - Country:US
Practice Address - Phone:540-656-2885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-06
Last Update Date:2009-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104556720111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor