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General NPI Number Information
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NPI Number | 1871918201
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Entity Type | Organization
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Legal Business Name | SELEME CHIROPRACTIC AND ALTERNATIVE HEALTHCARE P L C
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Dates
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Enumeration Date | 02/21/2014
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Last Update Date | 03/06/2014
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Provider Practice Location Address
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Address Line | 10395 DEMOCRACY LN STE A
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City | FAIRFAX
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State | VA
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Zip | 22030-2540
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Country | US
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Telephone | 703-273-0573
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Fax | 703-273-7056
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Provider Business Mailing Address
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Address Line | 10395 DEMOCRACY LN STE A
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City | FAIRFAX
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State | VA
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Zip | 22030-2540
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Country | US
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Telephone | 703-273-0573
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Fax | 703-273-7056
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Authorized Official
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Title or Position | DOCTOR OF CHIROPRACTIC/CHIROPRACTOR
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Name | DR. VENUS A SELEME
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Credential | D.C.
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Telephone | 703-273-0573
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NN1001X
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Taxonomy Name | Nutrition Chiropractor
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License Number | 1957
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License Number State | VA
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