Provider Demographics
NPI:1386966125
Name:BLUEBIRD FAMILY CHIROPRACTIC, LLC
Entity type:Organization
Organization Name:BLUEBIRD FAMILY CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:HADLEY
Authorized Official - Last Name:CHAMBERS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:804-824-0110
Mailing Address - Street 1:200 NAT TURNER BLVD S STE 200B
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-2998
Mailing Address - Country:US
Mailing Address - Phone:804-824-0110
Mailing Address - Fax:
Practice Address - Street 1:229 NW BLUE PKWY
Practice Address - Street 2:STE C
Practice Address - City:LEE'S SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64063-1800
Practice Address - Country:US
Practice Address - Phone:816-246-5300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-22
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010002022111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty