Individual
DR. BRIAN KEITH WIDENER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC, RN, CRNA
Contact information
Practice address
16000 JOHNSTON MEMORIAL DR, ABINGDON, VA 24211-7664
(276) 258-1000
(276) 258-1405
Mailing address
831 SHULER HOLLOW RD, CHILHOWIE, VA 24319-5647
(276) 780-2960
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
0104555564
VA
367500000X
Certified Registered Nurse Anesthetist
Primary
0024175795
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
227319
ANTHEM BC/BS
VA
Enumeration date
11/02/2006
Last updated
03/19/2018
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