Healthcare Provider Details

I. General information

NPI: 1639232341
Provider Name (Legal Business Name): SAMER MASRI D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: SAM MASRI D.C.

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 08/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 FAIRFAX DR STE 12
ARLINGTON VA
22203-1762
US

IV. Provider business mailing address

3801 FAIRFAX DR STE 12
ARLINGTON VA
22203-1762
US

V. Phone/Fax

Practice location:
  • Phone: 703-243-7878
  • Fax: 703-243-7880
Mailing address:
  • Phone: 703-243-7878
  • Fax: 703-243-7880

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number0104556660
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: