Provider Demographics
NPI:1720259062
Name:WINSTON CHIROPRACTIC CARE, P.C.
Entity Type:Organization
Organization Name:WINSTON CHIROPRACTIC CARE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:BRADBY
Authorized Official - Last Name:WINSTON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:804-754-2380
Mailing Address - Street 1:11175 RIDGEFIELD PKWY
Mailing Address - Street 2:SUITE 103
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23233-3572
Mailing Address - Country:US
Mailing Address - Phone:804-754-2380
Mailing Address - Fax:804-754-2390
Practice Address - Street 1:11175 RIDGEFIELD PKWY
Practice Address - Street 2:SUITE 103
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23233-3572
Practice Address - Country:US
Practice Address - Phone:804-754-2380
Practice Address - Fax:804-754-2390
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-14
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104002056111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC08289OtherMEDICARE PTAN