1477747558 NPI number — KEYSVILLE CHIROPRACTIC PLC

Table of content: PETER SCOTT LEVIN MD (NPI 1568570364)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477747558 NPI number — KEYSVILLE CHIROPRACTIC PLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KEYSVILLE CHIROPRACTIC PLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
COMMUNITY CHIROPRACTIC, PLC
Provider Other Organization Name Type Code:
4
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1477747558
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/19/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 136
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KEYSVILLE
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23947-0136
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
434-315-5868
Provider Business Mailing Address Fax Number:
434-315-5989

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
176 KING STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KEYSVILLE
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23947-5103
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
434-736-9895
Provider Business Practice Location Address Fax Number:
434-736-9897
Provider Enumeration Date:
08/30/2007

Additional Information

Authorized Official

Authorized Official Last Name:
SCHRIER
Authorized Official First Name:
MATTHEW
Authorized Official Middle Name:
M
Authorized Official Title or Position:
MEMBER
Authorized Official Telephone Number:
434-315-5868

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  0104556537 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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