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Organization
CHILDRESS CHIROPRACTIC, SPINAL REHAB & WELLNESS
Active
Organization
CHILDRESS CHIROPRACTIC, SPINAL REHAB & WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN LEWIS CHILDRESS D.C. (OWNER)
(276) 889-1314
Entity
Organization
Contact information
Practice address
619 W MAIN ST STE B, LEBANON, VA 24266-3809
(276) 889-1314
(276) 889-4125
Mailing address
PO BOX 1300, 619 W MAIN ST STE B, LEBANON, VA 24266-1300
(276) 889-1314
(276) 889-4125
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0104-001354
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000300608
—
VA
01
—
236332
ANTHEM
VA
01
—
5010623
AETNA
VA
Enumeration date
07/04/2006
Last updated
04/17/2008
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