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General NPI Number Information
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NPI Number | 1760511653
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Entity Type | Organization
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Legal Business Name | MAKDA CHIROPRACTIC HEALTH CENTER, P.C.
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Dates
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Enumeration Date | 03/05/2007
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Last Update Date | 09/15/2008
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Provider Practice Location Address
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Address Line | 5208 DAWES AVE
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City | ALEXANDRIA
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State | VA
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Zip | 22311-1404
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Country | US
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Telephone | 703-933-3838
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Fax | 703-933-3837
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Provider Business Mailing Address
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Address Line | 5208 DAWES AVE
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City | ALEXANDRIA
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State | VA
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Zip | 22311-1404
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Country | US
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Telephone | 703-933-3838
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Fax | 703-933-3837
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Authorized Official
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Title or Position | PRESIDENT
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Name | MAKDA GETACHEW
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Credential | D.C.
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Telephone | 703-933-3838
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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 | 0104555769
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License Number State | VA
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