Provider Demographics
NPI:1851625032
Name:FLESHOOD CHIROPRACTIC PC
Entity Type:Organization
Organization Name:FLESHOOD CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KELL
Authorized Official - Middle Name:W
Authorized Official - Last Name:FLESHOOD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:434-447-8996
Mailing Address - Street 1:PO BOX 794
Mailing Address - Street 2:
Mailing Address - City:SOUTH HILL
Mailing Address - State:VA
Mailing Address - Zip Code:23970-0794
Mailing Address - Country:US
Mailing Address - Phone:434-447-8996
Mailing Address - Fax:434-955-2582
Practice Address - Street 1:107 N BRUNSWICK AVE
Practice Address - Street 2:
Practice Address - City:SOUTH HILL
Practice Address - State:VA
Practice Address - Zip Code:23970-1909
Practice Address - Country:US
Practice Address - Phone:434-447-8996
Practice Address - Fax:434-955-2582
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-22
Last Update Date:2009-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty