Provider Demographics
NPI:1275806192
Name:DOROSKI CHIROPRACTIC
Entity Type:Organization
Organization Name:DOROSKI CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:DOROSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DACNB, DC
Authorized Official - Phone:703-730-9588
Mailing Address - Street 1:3122 GOLANSKY BLVD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-4267
Mailing Address - Country:US
Mailing Address - Phone:703-730-9588
Mailing Address - Fax:
Practice Address - Street 1:3122 GOLANSKY BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-4267
Practice Address - Country:US
Practice Address - Phone:703-730-9588
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-23
Last Update Date:2012-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104001511111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN0400XChiropractic ProvidersChiropractorNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAU61328Medicare UPIN