Organization
COMMONWEALTH CHIROPRACTIC CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS R FONTEYNE DC (PRESIDENT)
(434) 929-4999
Entity
Organization
Contact information
Practice address
3756 SOUTH AMHERST HIGHWAY, SUITE 100, MADISON HEIGHTS, VA 24572
(434) 929-4999
(434) 929-4997
Mailing address
3756 SOUTH AMHERST HIGHWAY, SUITE 100, MADISON HEIGHTS, VA 24572
(434) 929-4999
(434) 929-4997
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0104001637
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
263552
ANTHEM
VA
01
—
2995862
CIGNA
VA
01
—
350040203
RAILROAD MEDICARE
VA
Enumeration date
07/29/2008
Last updated
08/11/2008
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