Provider Demographics
NPI:1952496655
Name:NIEDER, TODD ALLEN (DC)
Entity Type:Individual
Prefix:MR
First Name:TODD
Middle Name:ALLEN
Last Name:NIEDER
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 1:620 NEFF AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801
Mailing Address - Country:US
Mailing Address - Phone:540-434-6400
Mailing Address - Fax:540-434-2188
Practice Address - Street 1:620 NEFF AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801
Practice Address - Country:US
Practice Address - Phone:540-434-6400
Practice Address - Fax:540-434-2188
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104556171111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
095974Medicare UPIN