Organization
FOOTHILLS CHIROPRACTIC CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HOLLY WELTY MILLER D.C. (OWNER)
(336) 648-2725
Entity
Organization
Contact information
Practice address
101 1ST ST NW, SUITE 1B, PULASKI, VA 24301-5605
(336) 648-2725
Mailing address
101 1ST ST NW, SUITE 1B, PULASKI, VA 24301-5605
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0104555784
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1396846051
PROVIDER NPI
VA
01
—
VVC826A
PROVIDER PTAN
VA
Enumeration date
08/27/2014
Last updated
08/27/2014
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