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General NPI Number Information
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NPI Number | 1710992136
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Entity Type | Organization
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Legal Business Name | PATRIOT CHIROPRACTIC CENTER P.L.L.C.
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Dates
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Enumeration Date | 07/31/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3915 OLD LEE HWY STE 22C
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City | FAIRFAX
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State | VA
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Zip | 22030-2432
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Country | US
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Telephone | 703-385-7007
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Fax | 703-385-4384
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Provider Business Mailing Address
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Address Line | 3915 OLD LEE HWY STE 22C
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City | FAIRFAX
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State | VA
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Zip | 22030-2432
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Country | US
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Telephone | 703-385-7007
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Fax | 703-385-4384
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MISS SARAH MARIE CURLES
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Credential |
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Telephone | 703-385-7007
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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 | 0104000903
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License Number State | VA
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