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General NPI Number Information
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NPI Number | 1376950576
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Entity Type | Organization
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Legal Business Name | HOME HEALTH CHIROPRACTIC & PHYSICAL THERAPY
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Dates
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Enumeration Date | 07/20/2014
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Last Update Date | 07/20/2014
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Provider Practice Location Address
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Address Line | 7787 LEESBURG PIKE SUITE B
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City | FALLS CHURCH
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State | VA
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Zip | 22043-2412
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Country | US
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Telephone | 703-662-3238
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Fax | 703-662-5870
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Provider Business Mailing Address
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Address Line | 800 4TH ST SW APT# S307
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City | WASHINGTON
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State | DC
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Zip | 20024-3032
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Country | US
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Telephone | 703-662-3238
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Fax | 703-662-5870
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Authorized Official
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Title or Position | OWNER/CHIROPRACTOR
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Name | DR. AMIRREZA AZAD
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Credential | D.C.
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Telephone | 301-706-9093
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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 | 0104556844
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License Number State | VA
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