Organization
INTEGRATED LIFE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN P DICKERT D.C. (OWNER)
(434) 227-7149
Entity
Organization
Contact information
Practice address
103 S PANTOPS DR, SUITE 105, CHARLOTTESVILLE, VA 22911-8617
(434) 227-7149
Mailing address
103 SOUTH PANTOPS DR., SUITE 105, CHARLOTTESVILLE, VIRGINIA 22911
(434) 227-7149
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0104001870
VA
Other
Enumeration date
12/18/2015
Last updated
12/18/2015
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