| NPI | 1205849072 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY KENNETH FODDRELL Owner 804-330-9830 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: VA 0104555717) |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2020-08-22 |