Provider Demographics
NPI:1265077820
Name:ZEGEYE, BLAIN ABIY (DC)
Entity type:Individual
Prefix:
First Name:BLAIN
Middle Name:ABIY
Last Name:ZEGEYE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7327 TIMBERLAKE RD
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502-2318
Mailing Address - Country:US
Mailing Address - Phone:434-237-0413
Mailing Address - Fax:434-237-1372
Practice Address - Street 1:7327 TIMBERLAKE RD
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502-2318
Practice Address - Country:US
Practice Address - Phone:434-237-0413
Practice Address - Fax:434-237-1372
Is Sole Proprietor?:No
Enumeration Date:2019-11-07
Last Update Date:2019-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104557611111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor