Provider Demographics
NPI:1124849583
Name:MCCONKEY CHIROPRACTIC, LLC
Entity type:Organization
Organization Name:MCCONKEY CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCONKEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:434-525-4588
Mailing Address - Street 1:1499 CROSSINGS CENTER DR STE A
Mailing Address - Street 2:
Mailing Address - City:FOREST
Mailing Address - State:VA
Mailing Address - Zip Code:24551-5040
Mailing Address - Country:US
Mailing Address - Phone:434-525-4588
Mailing Address - Fax:
Practice Address - Street 1:1499 CROSSINGS CENTER DR STE A
Practice Address - Street 2:
Practice Address - City:FOREST
Practice Address - State:VA
Practice Address - Zip Code:24551-5040
Practice Address - Country:US
Practice Address - Phone:434-525-4588
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-18
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty