Provider Demographics
NPI:1831283902
Name:PARMITER, JON KYLE (DC)
Entity Type:Individual
Prefix:DR
First Name:JON
Middle Name:KYLE
Last Name:PARMITER
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 1:5265 PROVIDENCE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23464-4206
Mailing Address - Country:US
Mailing Address - Phone:757-557-0010
Mailing Address - Fax:757-557-0060
Practice Address - Street 1:5265 PROVIDENCE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23464-4206
Practice Address - Country:US
Practice Address - Phone:757-557-0010
Practice Address - Fax:757-557-0060
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104001644111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U64344Medicare UPIN