Provider Demographics
NPI:1831803915
Name:CAN-AM CHIROPRACTIC AND WELLNESS
Entity type:Organization
Organization Name:CAN-AM CHIROPRACTIC AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER, CHIROPRACTIC PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:RILEY
Authorized Official - Middle Name:
Authorized Official - Last Name:DURBANO
Authorized Official - Suffix:
Authorized Official - Credentials:DC, ATC
Authorized Official - Phone:810-819-7212
Mailing Address - Street 1:150 OLDE GREENWICH DR STE 100
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22408-4063
Mailing Address - Country:US
Mailing Address - Phone:540-395-5985
Mailing Address - Fax:
Practice Address - Street 1:150 OLDE GREENWICH DR STE 100
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22408-4063
Practice Address - Country:US
Practice Address - Phone:540-395-5985
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-12
Last Update Date:2023-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic TrainerGroup - Multi-Specialty