Organization
304 CHIROPRACTIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JON-TYLER ROACH DC (OWNER)
(304) 638-3160
Entity
Organization
Contact information
Practice address
6468 FARMDALE RD, BARBOURSVILLE, WV 25504-1330
(304) 743-1261
(304) 390-6015
Mailing address
6468 FARMDALE RD, BARBOURSVILLE, WV 25504-1330
(304) 733-4038
(304) 733-4036
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Enumeration date
06/18/2019
Last updated
09/20/2019
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