Healthcare Provider Details

I. General information

NPI: 1073105318
Provider Name (Legal Business Name): TINA PATEL DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2021
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

754 WALKER RD
GREAT FALLS VA
22066-2654
US

IV. Provider business mailing address

2498 CURIE CT
HERNDON VA
20171-6101
US

V. Phone/Fax

Practice location:
  • Phone: 703-757-5817
  • Fax:
Mailing address:
  • Phone: 973-668-1446
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number0104558129
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: