Provider Demographics
NPI:1891893350
Name:AFOR, JOSEPH DOE (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:DOE
Last Name:AFOR
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 1:532 INDEPENDENCE BLVD
Mailing Address - Street 2:PEMBROKE PARK SHOPPES
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-2221
Mailing Address - Country:US
Mailing Address - Phone:757-456-5222
Mailing Address - Fax:757-456-2998
Practice Address - Street 1:532 INDEPENDENCE BLVD
Practice Address - Street 2:PEMBROKE PARK SHOPPES
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-2221
Practice Address - Country:US
Practice Address - Phone:757-456-5222
Practice Address - Fax:757-456-2998
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104556319111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
V09187Medicare UPIN