Provider Demographics
NPI:1295604726
Name:SEGALL, MADELINE MARIE (DC, BS)
Entity type:Individual
Prefix:
First Name:MADELINE
Middle Name:MARIE
Last Name:SEGALL
Suffix:
Gender:F
Credentials:DC, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4200B TECHNOLOGY CT
Mailing Address - Street 2:
Mailing Address - City:CHANTILLY
Mailing Address - State:VA
Mailing Address - Zip Code:20151-1214
Mailing Address - Country:US
Mailing Address - Phone:571-482-4052
Mailing Address - Fax:571-485-2458
Practice Address - Street 1:4200B TECHNOLOGY CT
Practice Address - Street 2:
Practice Address - City:CHANTILLY
Practice Address - State:VA
Practice Address - Zip Code:20151-1214
Practice Address - Country:US
Practice Address - Phone:571-482-4052
Practice Address - Fax:571-485-2458
Is Sole Proprietor?:No
Enumeration Date:2025-11-03
Last Update Date:2025-11-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0104558136111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor