Provider Demographics
NPI:1902807944
Name:FORAND, DORINE VINETTA (DC)
Entity Type:Individual
Prefix:DR
First Name:DORINE
Middle Name:VINETTA
Last Name:FORAND
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1940 MT PLEASANT RD
Mailing Address - Street 2:
Mailing Address - City:PAMPLIN
Mailing Address - State:VA
Mailing Address - Zip Code:23958-3619
Mailing Address - Country:US
Mailing Address - Phone:434-248-6633
Mailing Address - Fax:
Practice Address - Street 1:15828 RICHMOND HWY
Practice Address - Street 2:
Practice Address - City:PAMPLIN
Practice Address - State:VA
Practice Address - Zip Code:23958
Practice Address - Country:US
Practice Address - Phone:434-248-6633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-01
Last Update Date:2008-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX008288111N00000X
VA0104000723111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor