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General NPI Number Information
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NPI Number | 1689328155
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Entity Type | Organization
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Legal Business Name | 360 CHIROPRACTIC & REHAB
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Dates
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Enumeration Date | 02/03/2022
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Last Update Date | 02/03/2022
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Provider Practice Location Address
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Address Line | 4000 FAIRFAX DR APT 701
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City | ARLINGTON
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State | VA
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Zip | 22203-1127
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Country | US
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Telephone | 703-507-8446
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Fax |
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Provider Business Mailing Address
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Address Line | 4000 FAIRFAX DR APT 701
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City | ARLINGTON
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State | VA
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Zip | 22203-1127
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Country | US
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Telephone | 703-507-8446
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. NATHANIEL D TREBACH
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Credential | DC
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Telephone | 703-507-8446
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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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