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General NPI Number Information
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NPI Number | 1700027091
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Entity Type | Organization
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Legal Business Name | CHIRO PHYSICAL MEDICINE, LLC
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Dates
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Enumeration Date | 03/16/2009
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Last Update Date | 03/16/2009
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Provider Practice Location Address
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Address Line | 3801 FAIRFAX DR STE 12
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City | ARLINGTON
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State | VA
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Zip | 22203-1762
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Country | US
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Telephone | 703-243-7878
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Fax | 703-243-7880
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Provider Business Mailing Address
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Address Line | 3801 FAIRFAX DR STE 12
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City | ARLINGTON
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State | VA
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Zip | 22203-1762
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Country | US
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Telephone | 703-243-7878
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Fax | 703-243-7880
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. SAM MASRI
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Credential | D.C.
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Telephone | 708-369-3002
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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 | 0104556660
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License Number State | VA
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