Organization
VANDYKE CHIROPRACTIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRADLEY DEAN VANDYKE DC (CLINIC DIRECTOR)
(276) 597-8387
Entity
Organization
Contact information
Practice address
1779 LOVERS GAP ROAD, VANSANT, VA 24656
(276) 597-8387
(276) 597-2154
Mailing address
PO BOX 855, VANSANT, VA 24656-0855
(276) 597-8387
(276) 597-2154
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
0104001184
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7600037000
—
WV
Enumeration date
04/27/2007
Last updated
11/28/2011
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