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General NPI Number Information
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NPI Number | 1538246897
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Entity Type | Individual
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Provider Name | SUZANNE DUDKO D.C.
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Gender | Female
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 11/18/2014
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Provider Practice Location Address
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Address Line | 9010 LORTON STATION BLVD SUITE 110
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City | LORTON
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State | VA
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Zip | 22079-4792
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Country | US
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Telephone | 703-436-2207
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Fax | 703-879-3484
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Provider Business Mailing Address
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Address Line | 9010 LORTON STATION BLVD SUITE 110
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City | LORTON
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State | VA
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Zip | 22079-4792
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Country | US
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Telephone | 703-436-2207
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Fax | 703-879-3484
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 0104556122
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License Number State | VA
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