| NPI | 1164619706 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAWANDA HACKLEY Manger 240-766-0300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: VA 0104556518) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: VA 0104556529) |
| 111NR0200X Chiropractor, Radiology (Licence: VA 0104556518) | |
| 111NR0400X (Licence: VA 0104556529) | |
| Enumeration Date | 2007-09-27 |
| Last Update Date | 2007-09-27 |