Organization
BEA, LLC
Active
Other names
TOTAL HEALTH CHIROPRACTIC CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN F SHIELDS (BILLING MANAGER)
(804) 282-9133
Entity
Organization
Contact information
Practice address
5705 SALEM RUN BLVD, SUITE 100, FREDERICKSBURG, VA 22407-7119
(540) 786-4882
(540) 786-4893
Mailing address
5705 SALEM RUN BLVD, SUITE 100, FREDERICKSBURG, VA 22407-7119
(540) 786-4882
(540) 786-4893
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0104555602
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0104555602
VIRGINIA MEDICAL LICENSE NUMBER
VA
Enumeration date
06/08/2011
Last updated
06/08/2011
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