Individual
DR. JEFFREY KENNETH FODDRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
1570 EARLY SETTLERS RD, NORTH CHESTERFIELD, VA 23235-4458
(804) 330-9830
(804) 421-0869
Mailing address
1570 EARLY SETTLERS RD, NORTH CHESTERFIELD, VA 23235-4458
(804) 330-9830
(804) 421-0869
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0104001922
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
114440
ANTHEM
VA
Enumeration date
06/10/2005
Last updated
02/20/2015
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