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General NPI Number Information
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NPI Number | 1578430229
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Entity Type | Organization
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Legal Business Name | PROACTIVE CHIROPRACTIC CORP
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Dates
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Enumeration Date | 10/18/2025
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Last Update Date | 10/18/2025
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Provider Practice Location Address
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Address Line | 5105A BACKLICK RD
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City | ANNANDALE
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State | VA
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Zip | 22003-6005
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Country | US
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Telephone | 703-642-8685
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Fax |
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Provider Business Mailing Address
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Address Line | 5105A BACKLICK RD
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City | ANNANDALE
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State | VA
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Zip | 22003-6005
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DOCTOR OF CHIROPRACTIC
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Name | MONICA RIZKALLA
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Credential | DC
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Telephone | 301-717-2752
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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 |
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License Number State |
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