Mountain State Chiropractic

LBN: Mountain State Chiropractic
Mountain State Chiropractic is an health care organization with primary practice located at 310 Market St , Man WV 25635-1321. The organization recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as the primary health care specialty. Mountain State Chiropractic can be contacted via phone (304) 583-6400, or through Ellis, Johnathan Matthew via phone (304) 583-6400.

Contact Information

Primary practice address
310 Market St Man WV 25635-1321
Phone: (304) 583-6400
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Ellis, Johnathan Matthew Doctor of Chiropractic (DC)
Phone: (304) 583-6400

Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X 823 West Virginia

Profile Details

NPI number 1366501447
LBN Legal business name Mountain State Chiropractic
DBA Doing business as
Authorized official Ellis, Johnathan Matthew Doctor of Chiropractic (DC)
Entity Organization
Organization subpart 1 No
Enumeration date Dec 6th, 2006
Last updated Aug 22nd, 2020 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366501447 NPPES
West Virginia MEDICAID 0208726000

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