Provider Demographics
NPI:1275678963
Name:DOLBERG, DAVID BARRY (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:BARRY
Last Name:DOLBERG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:DAVID
Other - Middle Name:BARRY
Other - Last Name:NORMANDY-DOLBERG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:8440 OLD KEENE MILL RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22152-2302
Mailing Address - Country:US
Mailing Address - Phone:703-569-1300
Mailing Address - Fax:703-569-1972
Practice Address - Street 1:8440 OLD KEENE MILL RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22152-2302
Practice Address - Country:US
Practice Address - Phone:703-569-1300
Practice Address - Fax:703-569-1972
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104000354111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
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