Provider Demographics
NPI:1881679132
Name:MCCRAY CHIROPRACTIC AND HEALTH RESTORATION CLINIC, INC.
Entity Type:Organization
Organization Name:MCCRAY CHIROPRACTIC AND HEALTH RESTORATION CLINIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-262-0700
Mailing Address - Street 1:214 S VIKING WAY
Mailing Address - Street 2:
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25401-5338
Mailing Address - Country:US
Mailing Address - Phone:304-262-0700
Mailing Address - Fax:304-262-2854
Practice Address - Street 1:214 S VIKING WAY
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25401-5338
Practice Address - Country:US
Practice Address - Phone:304-262-0700
Practice Address - Fax:304-262-2854
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-09
Last Update Date:2020-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0700149OtherCIGNA
WV001711430OtherMSBCBS
WV671135OtherUNITED HEALTH CARE
WA5315087OtherAETNA
WA5315087OtherAETNA
WVMC0462944Medicare ID - Type UnspecifiedMEDICARE DOCTOR PROVIDER
WV0700149OtherCIGNA