Provider Demographics
NPI:1932564283
Name:PRAX FAMILYCHIROPRACTIC,LLC
Entity Type:Organization
Organization Name:PRAX FAMILYCHIROPRACTIC,LLC
Other - Org Name:CHRONIC CARE CHARLOTTESVILLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:CURTIS
Authorized Official - Last Name:PRAX
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:434-977-5433
Mailing Address - Street 1:300 HICKMAN RD STE 301
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-3554
Mailing Address - Country:US
Mailing Address - Phone:434-977-5433
Mailing Address - Fax:888-241-8375
Practice Address - Street 1:300 HICKMAN RD STE 301
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-3554
Practice Address - Country:US
Practice Address - Phone:434-977-5433
Practice Address - Fax:888-241-8375
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-30
Last Update Date:2016-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104556326111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty