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General NPI Number Information
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NPI Number | 1457705576
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Entity Type | Organization
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Legal Business Name | HOWARD CHIROPRACTIC CLINIC
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Dates
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Enumeration Date | 04/14/2016
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Last Update Date | 06/27/2016
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Provider Practice Location Address
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Address Line | 1980 GALLOWS RD SUITE 205
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City | VIENNA
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State | VA
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Zip | 22182-3913
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Country | US
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Telephone | 703-442-0800
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Fax | 703-442-0808
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Provider Business Mailing Address
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Address Line | 1980 GALLOWS RD SUITE 205
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City | VIENNA
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State | VA
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Zip | 22182-3913
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Country | US
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Telephone | 703-442-0800
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Fax | 703-442-0808
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Authorized Official
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Title or Position | OWNER/ CHIROPRACTOR
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Name | JESSICA HANNAH-QUEEN HOWARD
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Credential | D.C.
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Telephone | 703-442-0800
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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 | 0104557054
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License Number State | VA
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