Provider Demographics
NPI:1245365980
Name:DOCTORS' CHIROPRACTIC & REHAB, PC
Entity type:Organization
Organization Name:DOCTORS' CHIROPRACTIC & REHAB, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:U
Authorized Official - Last Name:ROODMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:804-359-1768
Mailing Address - Street 1:3536 GROVE AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23221-2200
Mailing Address - Country:US
Mailing Address - Phone:804-359-1768
Mailing Address - Fax:804-359-8344
Practice Address - Street 1:3536 GROVE AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23221-2200
Practice Address - Country:US
Practice Address - Phone:804-359-1768
Practice Address - Fax:804-359-8344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305002177225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA=========OtherFEDERAL TAX ID