Provider Demographics
NPI:1659597060
Name:SHENANDOAH CHIROPRACTIC PC
Entity Type:Organization
Organization Name:SHENANDOAH CHIROPRACTIC PC
Other - Org Name:SHENANDOAH CLINIC OF CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:DENNIS
Authorized Official - Last Name:KEEFE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:540-442-8555
Mailing Address - Street 1:2040 DEYERLE AVENUE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801
Mailing Address - Country:US
Mailing Address - Phone:540-442-8555
Mailing Address - Fax:540-442-9555
Practice Address - Street 1:2040 DEYERLE AVENUE
Practice Address - Street 2:SUITE 103
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801
Practice Address - Country:US
Practice Address - Phone:540-442-8555
Practice Address - Fax:540-442-9555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104556330111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty