Basic Information
| Provider Information | |||||||||
| NPI: | 1245405265 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | DR TODD M MACDOWALL PC | ||||||||
| LastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 103 ANNJO CT | ||||||||
| Address2: | |||||||||
| City: | FOREST | ||||||||
| State: | VA | ||||||||
| PostalCode: | 24551 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4344552484 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 103 ANNJO CT | ||||||||
| Address2: | |||||||||
| City: | FOREST | ||||||||
| State: | VA | ||||||||
| PostalCode: | 24551 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4344552484 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/30/2008 | ||||||||
| LastUpdateDate: | 07/10/2008 | ||||||||
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| AuthorizedOfficialLastName: | MACDOWALL | ||||||||
| AuthorizedOfficialFirstName: | TODD | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | DOCTOR OWNER | ||||||||
| AuthorizedOfficialTelephone: | 4344552484 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | DC | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 111N00000X | 0104556550 | VA | N | 193200000X MULTI-SPECIALTY GROUP | Chiropractic Providers | Chiropractor | 111N00000X | 0104001115 | VA | Y | 193200000X MULTI-SPECIALTY GROUP | Chiropractic Providers | Chiropractor |
No ID Information.