MEDICARE: LAUREN DODDS D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	0104557033	VA

General Provider Information

NPI Number	:	1205170677
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN DODDS D.C.

Provider Business Mailing Address
First Line	:	3313 DUKE ST
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22314-4522
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3313 DUKE ST
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22314-4522
Country	:	US
Telephone Number	:	703-823-3704
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/24/2012
Last Update Date	:	11/24/2012

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