Provider Demographics
NPI:1942675772
Name:MCDADE, KEVIN D (DC)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:D
Last Name:MCDADE
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 1:13146 MIDLOTHIAN TPKE
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113-4200
Mailing Address - Country:US
Mailing Address - Phone:804-499-6020
Mailing Address - Fax:804-499-6030
Practice Address - Street 1:13146 MIDLOTHIAN TPKE
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23113-4200
Practice Address - Country:US
Practice Address - Phone:804-499-6020
Practice Address - Fax:804-499-6030
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-04
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104557460111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty