Provider Demographics
NPI:1174350383
Name:CHIROVIRGINIA LLC
Entity type:Organization
Organization Name:CHIROVIRGINIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCUTCHEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:804-664-5898
Mailing Address - Street 1:14241 MIDLOTHIAN TPKE # 190
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113-6500
Mailing Address - Country:US
Mailing Address - Phone:804-664-5898
Mailing Address - Fax:804-800-4800
Practice Address - Street 1:11440 W BROAD ST
Practice Address - Street 2:
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23060-5821
Practice Address - Country:US
Practice Address - Phone:804-929-8789
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-19
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty