=====================================================
General NPI Number Information
=====================================================
NPI Number | 1255501334
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CYNTHIA HELEN DURAKIS DC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/05/2008
-----------------------------------------------------
Last Update Date | 03/10/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 517 WYTHE ST
-----------------------------------------------------
City | ALEXANDRIA
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22314-1917
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 703-739-0456
-----------------------------------------------------
Fax | 703-739-0032
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2101 MOUNT VERNON AVE
-----------------------------------------------------
City | ALEXANDRIA
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22301-1359
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 703-706-9500
-----------------------------------------------------
Fax | 703-842-8293
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 1240
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------