Provider Demographics
NPI:1932340676
Name:HARBOUR POINTE CHIROPRACTIC & WELLNESS CENTER, LLC
Entity Type:Organization
Organization Name:HARBOUR POINTE CHIROPRACTIC & WELLNESS CENTER, LLC
Other - Org Name:MIDLOTHIAN CHIROPRACTIC & WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:P
Authorized Official - Last Name:PLACIDE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:804-523-8028
Mailing Address - Street 1:14431 D SOMMERVILLE COURT
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113
Mailing Address - Country:US
Mailing Address - Phone:804-739-7700
Mailing Address - Fax:804-745-7804
Practice Address - Street 1:14431 D SOMMERVILLE COURT
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23113
Practice Address - Country:US
Practice Address - Phone:804-739-7700
Practice Address - Fax:804-745-7804
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-10
Last Update Date:2012-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104556260111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty