Provider Demographics
NPI:1689203622
Name:SUMMERFELT, NICHOLAS ROBERT (DC)
Entity Type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:ROBERT
Last Name:SUMMERFELT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 TOWN SQ UNIT 130
Mailing Address - Street 2:
Mailing Address - City:LOVETTSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20180-8556
Mailing Address - Country:US
Mailing Address - Phone:540-668-5837
Mailing Address - Fax:540-668-5838
Practice Address - Street 1:20 TOWN SQ UNIT 130
Practice Address - Street 2:
Practice Address - City:LOVETTSVILLE
Practice Address - State:VA
Practice Address - Zip Code:20180-8556
Practice Address - Country:US
Practice Address - Phone:540-668-5837
Practice Address - Fax:540-668-5838
Is Sole Proprietor?:No
Enumeration Date:2020-04-02
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104557904111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor