Provider Demographics
NPI:1881760999
Name:LABARBERA CHIROPRACTIC & WELLNESS CENTER, INCORPORATED
Entity type:Organization
Organization Name:LABARBERA CHIROPRACTIC & WELLNESS CENTER, INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:LABARBERA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:540-483-1811
Mailing Address - Street 1:60 MEADOW VIEW AVE
Mailing Address - Street 2:UNIT 100
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:VA
Mailing Address - Zip Code:24151-6824
Mailing Address - Country:US
Mailing Address - Phone:540-483-1811
Mailing Address - Fax:540-484-1538
Practice Address - Street 1:60 MEADOW VIEW AVE
Practice Address - Street 2:UNIT 100
Practice Address - City:ROCKY MOUNT
Practice Address - State:VA
Practice Address - Zip Code:24151-6824
Practice Address - Country:US
Practice Address - Phone:540-483-1811
Practice Address - Fax:540-484-1538
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2009-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104000594111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA350001107Medicare ID - Type Unspecified
VAU02309Medicare UPIN
VAGC1880Medicare PIN