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General NPI Number Information
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NPI Number | 1821278052
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Entity Type | Organization
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Legal Business Name | RAW CHIROPRATIC INC
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Dates
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Enumeration Date | 11/05/2007
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Last Update Date | 06/15/2010
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Provider Practice Location Address
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Address Line | 7010 LITTLE RIVER TPKE SUITE #430
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City | ANNANDALE
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State | VA
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Zip | 22003-3241
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Country | US
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Telephone | 703-354-2225
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Fax | 703-354-6119
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Provider Business Mailing Address
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Address Line | 7010 LITTLE RIVER TPKE SUITE #430
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City | ANNANDALE
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State | VA
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Zip | 22003-3241
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Country | US
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Telephone | 703-354-2225
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Fax | 703-354-6119
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | THERESA WALSH
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Credential |
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Telephone | 703-354-2225
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 0631768
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License Number State | VA
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