Individual
MS. MICHELLE REBECCA SEVERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
920 TANYARD RD, SUITE 102, ROCKY MOUNT, VA 24151-1543
(540) 483-3678
(540) 483-3820
Mailing address
920 TANYARD RD, SUITE G, ROCKY MOUNT, VA 24151-1543
(540) 483-4344
(844) 726-9867
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0104556868
VA
111N00000X
Chiropractor
DC010498
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C05545
MEDICARE GROUP PTAN
VA
Enumeration date
02/10/2010
Last updated
03/14/2017
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