MEDICARE: CHIROPRACTIC FAMILY LIFE CENTER

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	0104556071	VA

General Provider Information

NPI Number	:	1497842611
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHIROPRACTIC FAMILY LIFE CENTER

Provider Business Mailing Address
First Line	:	4731 ARLINGTON BLVD
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22203-2612
Country	:	US
Telephone Number	:	703-282-3357
Fax Number	:

Provider Business Practice Location Address
First Line	:	4731 ARLINGTON BLVD
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22203-2612
Country	:	US
Telephone Number	:	703-282-3357
Fax Number	:

Authorized Official
Title or Position	:	OWNER/DOCTOR
Name	:	DR. JENNIFER BRIANA MILLER
Credential	:	D.C.
Telephone Number	:	703-282-3357

Provider Enumeration Date	:	10/08/2006
Last Update Date	:	08/22/2020

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