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Organization

LOUISA CHIROPRACTIC CENTER, LLC

Active
Other names
Louisa Chiropractic Center
Organization subpart
No

Provider details

NPI number
Authorized official
DR. GLENN E. BOLEY D.C. (CLINIC DIRECTOR)
(540) 967-2522
Entity
Organization

Contact information

Practice address
506 E MAIN ST, LOUISA, VA 23093-4100
(540) 967-2522
(540) 967-5878
Mailing address
506 E MAIN ST, LOUISA, VA 23093-4100
(540) 967-2522
(540) 967-5878

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
01040000734
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010100089
VA
01
01040000734
STATE LICENSE TO PRACTICE
VA
Enumeration date
12/01/2008
Last updated
12/01/2008
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