Provider Demographics
NPI:1871267526
Name:VALHALLA TRAINING GROUNDS INC.
Entity Type:Organization
Organization Name:VALHALLA TRAINING GROUNDS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRANDI
Authorized Official - Middle Name:
Authorized Official - Last Name:SAID
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:563-468-0848
Mailing Address - Street 1:1749 E 54TH ST
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52807-2769
Mailing Address - Country:US
Mailing Address - Phone:563-387-9999
Mailing Address - Fax:
Practice Address - Street 1:1749 E 54TH ST
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52807-2769
Practice Address - Country:US
Practice Address - Phone:563-387-9999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-05
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty