Healthcare Provider Details

I. General information

NPI: 1508781535
Provider Name (Legal Business Name): AMIN HOMAYOUNFAR DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 HERNDON PKWY STE 130
HERNDON VA
20170-5526
US

IV. Provider business mailing address

950 HERNDON PKWY STE 130
HERNDON VA
20170-5526
US

V. Phone/Fax

Practice location:
  • Phone: 703-686-5663
  • Fax:
Mailing address:
  • Phone: 703-686-5663
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number0104558196
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: