Healthcare Provider Details

I. General information

NPI: 1902981236
Provider Name (Legal Business Name): MARTIN J SKOPP DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 BELLE VIEW BLVD SUITE A1
ALEXANDRIA VA
22307-6723
US

IV. Provider business mailing address

1701 BELLE VIEW BLVD SUITE A1
ALEXANDRIA VA
22307-6723
US

V. Phone/Fax

Practice location:
  • Phone: 703-721-9600
  • Fax: 703-768-3290
Mailing address:
  • Phone: 703-721-9600
  • Fax: 703-768-3290

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number0104001086
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number0104001086
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: