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Individual

MS. MEGHAN ANN CUSTER I

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DC

Contact information

Practice address
4422 IVY COMMONS, CHARLOTTESVILLE, VA 22903-7123
(434) 817-3666
Mailing address
4422 IVY COMMONS, CHARLOTTESVILLE, VA 22903-7123
(434) 825-5717

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0104002067
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
011082000
SOUTHERN HEALTH
VA
01
1914401229
MAIL HANDLERS
VA
01
293442
MAMSI/ ALLIANCE
VA
01
451931
ANTHEM
VA
01
700027234
CIGNA
VA
Enumeration date
05/23/2005
Last updated
10/27/2014
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