Provider Demographics
NPI:1487905899
Name:MCELWRATH, BILLIE DERONDA (DC)
Entity type:Individual
Prefix:DR
First Name:BILLIE
Middle Name:DERONDA
Last Name:MCELWRATH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7020 COLD HARBOR RD
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23111-5045
Mailing Address - Country:US
Mailing Address - Phone:804-730-2609
Mailing Address - Fax:
Practice Address - Street 1:7020 COLD HARBOR RD
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23111-5045
Practice Address - Country:US
Practice Address - Phone:804-730-2609
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-25
Last Update Date:2012-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104557019111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor