Individual
JEFFERSON KIRKLAND TEASS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
300 VIRGINIA AVE, VINTON, VA 24179
(540) 982-2920
(540) 342-4835
Mailing address
PO BOX 646, 300 VIRGINIA AVE, VINTON, VA 24179-0646
(540) 982-2920
(540) 342-4835
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0104000446
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
015913
ANTHEM BCBS VIRGINIA
—
Enumeration date
11/23/2005
Last updated
07/08/2007
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