Provider Demographics
NPI:1649381005
Name:MESSIAH & SON, INC.
Entity Type:Organization
Organization Name:MESSIAH & SON, INC.
Other - Org Name:CORNERSTONE CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:BRESNAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:757-491-4600
Mailing Address - Street 1:1917 LASKIN RD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-4283
Mailing Address - Country:US
Mailing Address - Phone:757-491-4600
Mailing Address - Fax:757-491-0578
Practice Address - Street 1:1917 LASKIN RD
Practice Address - Street 2:SUITE 108
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-4283
Practice Address - Country:US
Practice Address - Phone:757-491-4600
Practice Address - Fax:757-491-0578
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104000492111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VADG9138OtherRAILROAD MEDICARE GROUP NUMBER
VA043306OtherANTHEM BCBS
VAC10298Medicare PIN