Provider Demographics
NPI:1063438885
Name:POLLOCK, MICHAEL DENNIS (DC)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:DENNIS
Last Name:POLLOCK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2350 LOCH BRAEMAR DR
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23236-1602
Mailing Address - Country:US
Mailing Address - Phone:804-674-6106
Mailing Address - Fax:804-272-1442
Practice Address - Street 1:8707 FOREST HILL AVE
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23235-2431
Practice Address - Country:US
Practice Address - Phone:804-272-9191
Practice Address - Fax:804-272-1442
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2012-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104000305111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0812294OtherAETNA
VA350-043993OtherRAILROAD MEDICARE
VA027660OtherANTHEM
VA027660OtherANTHEM
VA0812294OtherAETNA