Individual
DR. SAMUEL KENNETH BOOTHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
340 N MAIN ST, STE 108, MARION, VA 24354
(276) 783-7005
(276) 783-8080
Mailing address
340 N MAIN ST, SUITE 108, MARION, VA 24354-3360
(276) 783-7005
(276) 783-8080
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0104555931
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
434850
ANTHEM
—
Enumeration date
06/27/2006
Last updated
12/16/2016
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