Provider Demographics
NPI:1346549532
Name:WARRENTON CHIROPRACTIC CENTER, LLC
Entity Type:Organization
Organization Name:WARRENTON CHIROPRACTIC CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:BREEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:540-349-7744
Mailing Address - Street 1:12613 VICTORY LAKES LOOP
Mailing Address - Street 2:
Mailing Address - City:BRISTOW
Mailing Address - State:VA
Mailing Address - Zip Code:20136-1274
Mailing Address - Country:US
Mailing Address - Phone:703-368-4040
Mailing Address - Fax:703-361-1177
Practice Address - Street 1:10 ROCK POINTE LN
Practice Address - Street 2:SUITE 6
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20186-2672
Practice Address - Country:US
Practice Address - Phone:540-349-7744
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-28
Last Update Date:2011-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104000765111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty