Provider Demographics
NPI:1336516509
Name:HEALING BOUTIQUES CHIROMED INC
Entity Type:Organization
Organization Name:HEALING BOUTIQUES CHIROMED INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THANG
Authorized Official - Middle Name:
Authorized Official - Last Name:DO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-208-7352
Mailing Address - Street 1:8408 ARLINGTON BLVD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-4608
Mailing Address - Country:US
Mailing Address - Phone:703-208-7352
Mailing Address - Fax:703-208-7245
Practice Address - Street 1:8408 ARLINGTON BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4608
Practice Address - Country:US
Practice Address - Phone:703-208-7352
Practice Address - Fax:703-208-7245
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-24
Last Update Date:2015-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty