Healthcare Provider Details

I. General information

NPI: 1093633976
Provider Name (Legal Business Name): ANTHONY NATHANAEL ALLEN DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 S PICKETT ST STE 201
ALEXANDRIA VA
22304-7208
US

IV. Provider business mailing address

109 CREIGHTON CT
MARTINSBURG WV
25404-7766
US

V. Phone/Fax

Practice location:
  • Phone: 703-678-9726
  • Fax:
Mailing address:
  • Phone: 240-397-3481
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number0104558192
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: