Provider Demographics
NPI:1225699234
Name:O'BRIEN, AIDAN (DC)
Entity Type:Individual
Prefix:DR
First Name:AIDAN
Middle Name:
Last Name:O'BRIEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 PINE ST SE STE 320
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22180-4861
Mailing Address - Country:US
Mailing Address - Phone:703-938-1421
Mailing Address - Fax:
Practice Address - Street 1:410 PINE ST SE STE 320
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22180-4861
Practice Address - Country:US
Practice Address - Phone:703-938-1421
Practice Address - Fax:703-938-1424
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-21
Last Update Date:2019-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04009111N00000X
VA0104-557606111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty