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General NPI Number Information
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NPI Number | 1881467538
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Entity Type | Organization
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Legal Business Name | PALMERCARE CHIROPRACTIC CHANTILLY LLC
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Dates
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Enumeration Date | 11/03/2023
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Last Update Date | 11/03/2023
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Provider Practice Location Address
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Address Line | 3910 CENTREVILLE RD STE 202
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City | CHANTILLY
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State | VA
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Zip | 20151-3280
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Country | US
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Telephone | 703-378-2698
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Fax |
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Provider Business Mailing Address
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Address Line | 46169 WESTLAKE DR STE 300
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City | STERLING
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State | VA
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Zip | 20165-5875
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Country | US
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Telephone | 703-421-2990
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | CASEY HOLM
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Credential |
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Telephone | 703-421-2990
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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 |
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License Number State |
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