Organization
BACK TO THE BEACH, INC
Active
Other names
Capitol Rehab
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELLIOT DAVID SHERMAN D.C. (PRESIDENT)
(757) 831-9128
Entity
Organization
Contact information
Practice address
1900 MONTICELLO AVE, NORFOLK, VA 23517-2339
(757) 831-9128
Mailing address
1900 MONTICELLO AVE, NORFOLK, VA 23517-2339
(757) 831-9128
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0104556338
VA
225100000X
Physical Therapist
2305203689
VA
Other
Enumeration date
10/09/2007
Last updated
10/09/2007
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