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General NPI Number Information
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NPI Number | 1639694599
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Entity Type | Organization
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Legal Business Name | SPRING CHIROPRACTIC
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Dates
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Enumeration Date | 08/11/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 44933 GEORGE WASHINGTON BLVD STE 120
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City | ASHBURN
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State | VA
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Zip | 20147-6301
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Country | US
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Telephone | 703-858-4645
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Fax | 703-858-4646
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Provider Business Mailing Address
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Address Line | 44933 GEORGE WASHINGTON BLVD STE 120
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City | ASHBURN
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State | VA
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Zip | 20147-6301
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Country | US
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Telephone | 703-858-4645
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Fax | 703-858-4646
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Authorized Official
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Title or Position | OWNER
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Name | DR. RYAN BORRELL
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Credential | D.C.
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Telephone | 703-858-4645
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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 | 0104-557361
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License Number State | VA
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