Provider Demographics
NPI:1336269935
Name:MONTPELIER FAMILY CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:MONTPELIER FAMILY CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SINGLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:M
Authorized Official - Last Name:NEISS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:804-883-3000
Mailing Address - Street 1:16603 MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:MONTPELIER
Mailing Address - State:VA
Mailing Address - Zip Code:23192-2660
Mailing Address - Country:US
Mailing Address - Phone:804-883-3000
Mailing Address - Fax:804-883-3060
Practice Address - Street 1:16603 MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:MONTPELIER
Practice Address - State:VA
Practice Address - Zip Code:23192-2660
Practice Address - Country:US
Practice Address - Phone:804-883-3000
Practice Address - Fax:804-883-3060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2011-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104556178111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAV02098Medicare UPIN