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General NPI Number Information
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NPI Number | 1336307933
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Entity Type | Organization
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Legal Business Name | HORIZON CHIROPRACTIC CLINIC
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Dates
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Enumeration Date | 05/30/2008
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Last Update Date | 11/03/2011
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Provider Practice Location Address
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Address Line | 3541 CHAIN BRIDGE RD SUITE 5
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City | FAIRFAX
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State | VA
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Zip | 22030-2793
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Country | US
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Telephone | 703-691-2225
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Fax | 703-691-2265
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Provider Business Mailing Address
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Address Line | 3541 CHAIN BRIDGE RD SUITE 5
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City | FAIRFAX
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State | VA
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Zip | 22030-2793
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Country | US
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Telephone | 703-691-2225
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Fax | 703-691-2265
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. ERIC DOUGLAS TERRELL
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Credential | DC
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Telephone | 703-691-2225
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 0104000794
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License Number State | VA
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