Provider Demographics
NPI:1710179593
Name:CHIRO-MED HEALTH CENTER INC
Entity Type:Organization
Organization Name:CHIRO-MED HEALTH CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:JINUS
Authorized Official - Last Name:TINOOSH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-316-0100
Mailing Address - Street 1:18853 FOREST RD
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502-4485
Mailing Address - Country:US
Mailing Address - Phone:434-316-0100
Mailing Address - Fax:434-316-0103
Practice Address - Street 1:18853 FOREST RD
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502-4485
Practice Address - Country:US
Practice Address - Phone:434-316-0100
Practice Address - Fax:434-316-0103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-15
Last Update Date:2020-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1710179593Medicare NSC