Provider Demographics
NPI:1720159718
Name:HUTTON CHIROPRACTIC HEALTH CENTER OF MARSHALL PC
Entity type:Organization
Organization Name:HUTTON CHIROPRACTIC HEALTH CENTER OF MARSHALL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:CARLTON
Authorized Official - Last Name:HUTTON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:540-364-2045
Mailing Address - Street 1:PO BOX 1053
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:VA
Mailing Address - Zip Code:20116
Mailing Address - Country:US
Mailing Address - Phone:540-364-2045
Mailing Address - Fax:540-364-3860
Practice Address - Street 1:8430 WEST MAIN STREET
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:VA
Practice Address - Zip Code:20115
Practice Address - Country:US
Practice Address - Phone:540-364-2045
Practice Address - Fax:540-364-3860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2013-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104000463111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA333242OtherANTHEM
VAC09690Medicare ID - Type Unspecified
VA333242OtherANTHEM