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General NPI Number Information
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NPI Number | 1679763429
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Entity Type | Organization
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Legal Business Name | ALEXANDER CHIROPRACTIC NEUROLOGY CENTER
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Dates
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Enumeration Date | 07/27/2007
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Last Update Date | 07/27/2007
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Provider Practice Location Address
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Address Line | 462 HERNDON PKWY SUITE 101
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City | HERNDON
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State | VA
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Zip | 20170-5234
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Country | US
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Telephone | 703-689-0762
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Fax | 703-689-0920
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Provider Business Mailing Address
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Address Line | 462 HERNDON PARKWAY SUITE 101
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City | HERNDON
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State | VA
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Zip | 20170-5234
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Country | US
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Telephone | 703-689-0762
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Fax | 703-689-0920
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Authorized Official
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Title or Position | OWNER
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Name | DR. DIANE ELIZABETH ALEXANDER
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Credential | D.C.
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Telephone | 703-689-0762
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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 | 0104000784
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License Number State | VA
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