Accident & Injury Chiropractic Center, Inc.
Organization Active NPI Chiropractor · Forest, VA
NPI 1629119045 · NPPES record last updated Aug 3, 2007
Key facts
- NPI
- 1629119045
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- Legal business name
- ACCIDENT & INJURY CHIROPRACTIC CENTER, INC.
- Practice address
- 306 Enterprise Dr Ste B
Forest, VA 24551-2644 - Phone
- (434) 385-6333
- Fax
- (434) 385-6330
- NPI assigned
- Feb 9, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Jessica Carleen Funicello, DC
- Title
- Secretary / Chiropractor
- Phone
- (434) 385-6333
Practitioners 5
-
Danny R Floyd, D.C.
-
Sean L Shull, DC
-
Nathan D Belcher, C.H.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20071023000398 | VA | Part B Supplier - Clinic/Group Practice | 9436245354 |
Receives reassigned benefits from 1 practitioner Practice locations: Spout Spring, VA; Forest, VA |
National Provider Directory
Locations
2237 E Cedar Ave
Flagstaff, AZ 86004
Phone (563) 340-5194
2708 N 4th St
Ste A-5
Flagstaff, AZ 86004
Phone (928) 774-7315
3012 Forest Hills Cir
Lynchburg, VA 24501
Phone (434) 384-1631
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | Yes |
Addresses
Primary practice location
306 Enterprise Dr Ste B
Forest, VA 24551-2644
Mailing address
320 Riverside Dr
Lynchburg, VA 24503-1319
Phone (434) 326-5761
Other names
- Appomattox Chiropractic & Rehab, Inc.
Other providers in Forest, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 3, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.