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Organization

FIRST COLONIAL CHIROPRACTIC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JASON A BRADECICH DC (OWNER)
(757) 496-4956
Entity
Organization

Contact information

Practice address
1139 FIRST COLONIAL RD, VIRGINIA BEACH, VA 23454-2402
(757) 496-4956
(757) 496-0197
Mailing address
1139 FIRST COLONIAL RD, VIRGINIA BEACH, VA 23454-2402
(757) 496-4956
(757) 496-0197

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0104555587
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
140415
ANTHEM
VA
Enumeration date
02/20/2008
Last updated
04/14/2008
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