Provider Demographics
NPI:1396138699
Name:SIKES CHIROPRACTIC
Entity type:Organization
Organization Name:SIKES CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:FULLLER
Authorized Official - Last Name:SIKES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:757-496-9698
Mailing Address - Street 1:2100 SANCTUARY CT
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-2257
Mailing Address - Country:US
Mailing Address - Phone:757-496-9698
Mailing Address - Fax:757-321-9073
Practice Address - Street 1:2304 KENSTOCK DR
Practice Address - Street 2:101
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-3354
Practice Address - Country:US
Practice Address - Phone:757-496-9698
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-10
Last Update Date:2015-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0304000608261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
VVD3870281OtherPTAN