Organization
VIRGINIA SPORT & SPINE INSTITUTE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY LOWES DC (PRESIDENT)
(434) 851-0091
Entity
Organization
Contact information
Practice address
2203 GRAVES MILL RD STE A, FOREST, VA 24551
(434) 851-0091
Mailing address
PO BOX 1128, FOREST, VA 24551-5128
(434) 851-0091
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0104556303
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0104556303
STATE LICENSE
VA
01
—
S5931580
STATE CORPORATION COMMISSION
VA
Enumeration date
05/15/2018
Last updated
07/24/2018
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