Provider Demographics
NPI:1760589964
Name:FIRST PRIORITY MEDICAL CHOICE
Entity Type:Organization
Organization Name:FIRST PRIORITY MEDICAL CHOICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:W
Authorized Official - Last Name:CHAMBERS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:304-263-4927
Mailing Address - Street 1:51 STREET OF DREAMS
Mailing Address - Street 2:
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25403-1134
Mailing Address - Country:US
Mailing Address - Phone:304-263-4927
Mailing Address - Fax:304-263-0682
Practice Address - Street 1:51 STREET OF DREAMS
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25403-1134
Practice Address - Country:US
Practice Address - Phone:304-263-4927
Practice Address - Fax:304-263-0682
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2009-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV312111N00000X
WV825111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV9292691Medicare PIN