Organization
ACTIVE WELLNESS CHIROPRACTIC PC
Active
Other names
Healthsource of Norfolk
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TRAVIS WAYNE DAVIS D.C (OWNER)
(757) 627-2222
Entity
Organization
Contact information
Practice address
1900 MONTICELLO AVE, NORFOLK, VA 23517-2339
(757) 627-2222
Mailing address
1900 MONTICELLO AVE, NORFOLK, VA 23517-2339
(757) 627-2222
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0104002072
VA
Other
Enumeration date
03/13/2014
Last updated
06/11/2014
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