Provider Demographics
NPI:1841456381
Name:DICKERSON, MEGHAN ANN (DC)
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:ANN
Last Name:DICKERSON
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 1:103A FREE BRIDGE LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-8446
Mailing Address - Country:US
Mailing Address - Phone:434-977-0777
Mailing Address - Fax:
Practice Address - Street 1:103A FREE BRIDGE LN
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-8446
Practice Address - Country:US
Practice Address - Phone:434-977-0777
Practice Address - Fax:434-977-8222
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-04
Last Update Date:2008-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104556648111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor