| NPI | 1750654497 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE SHORT Owner 703-781-4400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NS0005X Chiropractor, Sports Physician (Licence: VA 0104555886) |
| Enumeration Date | 2012-02-10 |
| Last Update Date | 2012-02-10 |