MEDICARE: PALMERCARE CHIROPRACTIC ALEXANDRIA LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1346092889
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PALMERCARE CHIROPRACTIC ALEXANDRIA LLC

Provider Business Mailing Address
First Line	:	46169 WESTLAKE DR STE 300
Second Line	:
City	:	STERLING
State	:	VA
Zip	:	20165-5875
Country	:	US
Telephone Number	:	703-421-2990
Fax Number	:

Provider Business Practice Location Address
First Line	:	7770 RICHMOND HWY STE D
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22306-2859
Country	:	US
Telephone Number	:	703-360-1011
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	CASEY HOLM
Credential	:
Telephone Number	:	713-829-7506

Provider Enumeration Date	:	04/05/2024
Last Update Date	:	04/05/2024

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