Provider Demographics
NPI:1669837688
Name:CORE CONCEPTS CHIROPRACTIC
Entity Type:Organization
Organization Name:CORE CONCEPTS CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:
Authorized Official - Last Name:POE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:703-723-4178
Mailing Address - Street 1:42882 TRURO PARISH DR
Mailing Address - Street 2:SUITE 207
Mailing Address - City:BROADLANDS
Mailing Address - State:VA
Mailing Address - Zip Code:20148-4456
Mailing Address - Country:US
Mailing Address - Phone:703-723-4178
Mailing Address - Fax:703-723-5424
Practice Address - Street 1:42882 TRURO PARISH DR
Practice Address - Street 2:SUITE 207
Practice Address - City:BROADLANDS
Practice Address - State:VA
Practice Address - Zip Code:20148-4456
Practice Address - Country:US
Practice Address - Phone:703-723-4178
Practice Address - Fax:703-723-5424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-17
Last Update Date:2016-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty