Healthcare Provider Details

I. General information

NPI: 1972929982
Provider Name (Legal Business Name): HOPSICKER WELLNESS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2014
Last Update Date: 03/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5901 KINGSTOWNE VILLAGE PKWY SUITE 100
ALEXANDRIA VA
22315-5880
US

IV. Provider business mailing address

5901 KINGSTOWNE VILLAGE PKWY SUITE 100 (PO BOX 150514)
ALEXANDRIA VA
22315-5880
US

V. Phone/Fax

Practice location:
  • Phone: 703-347-7530
  • Fax: 703-347-7531
Mailing address:
  • Phone: 703-347-7530
  • Fax: 703-347-7531

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number0104556533
License Number StateVA

VIII. Authorized Official

Name: DR. BENJAMIN D HOPSICKER
Title or Position: PRESIDENT, CHIROPRACTOR
Credential: D.C
Phone: 703-347-7530