MEDICARE: DR. CYNTHIA DURAKIS, PLLC

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	0104001240	VA

General Provider Information

NPI Number	:	1891022455
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR. CYNTHIA DURAKIS, PLLC

Provider Business Mailing Address
First Line	:	1240 N PITT ST
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22314-5600
Country	:	US
Telephone Number	:	703-739-0456
Fax Number	:

Provider Business Practice Location Address
First Line	:	1240 N PITT ST
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22314-5600
Country	:	US
Telephone Number	:	703-739-0456
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. CYNTHIA HELEN DURAKIS
Credential	:	DC
Telephone Number	:	703-739-0456

Provider Enumeration Date	:	11/03/2009
Last Update Date	:	11/03/2009

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