MEDICARE: SPRING CHIROPRACTIC

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	0104-557361	VA

General Provider Information

NPI Number	:	1639694599
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPRING CHIROPRACTIC

Provider Business Mailing Address
First Line	:	44933 GEORGE WASHINGTON BLVD STE 120
Second Line	:
City	:	ASHBURN
State	:	VA
Zip	:	20147-6301
Country	:	US
Telephone Number	:	703-858-4645
Fax Number	:	703-858-4646

Provider Business Practice Location Address
First Line	:	44933 GEORGE WASHINGTON BLVD STE 120
Second Line	:
City	:	ASHBURN
State	:	VA
Zip	:	20147-6301
Country	:	US
Telephone Number	:	703-858-4645
Fax Number	:	703-858-4646

Authorized Official
Title or Position	:	OWNER
Name	:	DR. RYAN BORRELL
Credential	:	D.C.
Telephone Number	:	703-858-4645

Provider Enumeration Date	:	08/11/2017
Last Update Date	:	07/21/2022

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Directions to “SPRING CHIROPRACTIC ” Practice Location

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