Life Chiropractic Clinic Of Stafford | |
147 Garrisonville Rd, Stafford, VA 22554-1523 | |
(540) 720-6000 | |
(540) 288-1913 |
Full Name | Life Chiropractic Clinic Of Stafford |
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Type | Facility |
Speciality | Chiropractor |
Location | 147 Garrisonville Rd, Stafford, Virginia |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1508133323 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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111N00000X | Chiropractor | 0104001099 (Virginia) | Primary |
Provider Name | Mark Edward Bryngelson |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1184653032 PECOS PAC ID: 6709051212 Enrollment ID: I20111213000043 |
Mailing Address | Practice Location Address |
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Life Chiropractic Clinic Of Stafford 147 Garrisonville Rd, Stafford, VA 22554-1523 Ph: (540) 720-6000 | Life Chiropractic Clinic Of Stafford 147 Garrisonville Rd, Stafford, VA 22554-1523 Ph: (540) 720-6000 |
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