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Organization
SPINAL SOURCE CHIROPRACTIC LLC
Active
Organization
SPINAL SOURCE CHIROPRACTIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TAYLOR BOLLIG D.C. (OWNER/CHIROPRACTOR)
(757) 642-4945
Entity
Organization
Contact information
Practice address
6546 HAMPTON ROADS PKWY, SUITE 112, SUFFOLK, VA 23435-3185
(757) 642-4945
(757) 977-1039
Mailing address
6546 HAMPTON ROADS PKWY, STE 112, SUFFOLK, VA 23435-3185
(757) 296-2225
(757) 977-1039
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
0104-557378
VA
111N00000X
Chiropractor
Primary
0104-557380
VA
111N00000X
Chiropractor
11140
FL
111N00000X
Chiropractor
11751
FL
Other
Enumeration date
01/28/2016
Last updated
05/04/2017
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