Provider Demographics
NPI:1710235189
Name:BRAIN & BODY HEALTH CENTER
Entity Type:Organization
Organization Name:BRAIN & BODY HEALTH CENTER
Other - Org Name:RIGGLEMAN SPORTS AND NUTRITION
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:K
Authorized Official - Last Name:WITGEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:517-282-2627
Mailing Address - Street 1:611 W JUBAL EARLY DR STE A
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-6501
Mailing Address - Country:US
Mailing Address - Phone:540-678-1212
Mailing Address - Fax:540-678-1123
Practice Address - Street 1:611 W JUBAL EARLY DR STE A
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-6501
Practice Address - Country:US
Practice Address - Phone:540-678-1212
Practice Address - Fax:540-678-1123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-16
Last Update Date:2014-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty