Organization
FREEDOM CHIROPRACTIC L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK ANTHONY GENTILE D.C. (MANAGER)
(540) 381-8700
Entity
Organization
Contact information
Practice address
360B ARBOR DR, CHRISTIANSBURG, VA 24073-6544
(540) 381-8700
(540) 381-8700
Mailing address
360B ARBOR DR, CHRISTIANSBURG, VA 24073-6544
(540) 381-8700
(540) 381-8700
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0104002024
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
174753
ANTHEM BC/BS PROVIDER NUM
VA
01
—
7196082
AETNA PROVIDER NUMBER
VA
Enumeration date
10/25/2006
Last updated
08/22/2020
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