Provider Demographics
NPI:1013488717
Name:FBURG CHIRO LLC
Entity Type:Organization
Organization Name:FBURG CHIRO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DC/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:EDWIN
Authorized Official - Last Name:MCKINNEY
Authorized Official - Suffix:III
Authorized Official - Credentials:DC
Authorized Official - Phone:717-865-6183
Mailing Address - Street 1:PO BOX 152
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17026-0152
Mailing Address - Country:US
Mailing Address - Phone:717-865-6183
Mailing Address - Fax:
Practice Address - Street 1:103 SOUTH CENTER STREET
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:PA
Practice Address - Zip Code:17026-0152
Practice Address - Country:US
Practice Address - Phone:717-865-6183
Practice Address - Fax:717-865-0140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-07
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty