Provider Demographics
NPI:1366019325
Name:INVIGORATE CHIROPRACTIC CARE LLC
Entity Type:Organization
Organization Name:INVIGORATE CHIROPRACTIC CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANN
Authorized Official - Middle Name:OLIVIA
Authorized Official - Last Name:REILLY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:703-919-6753
Mailing Address - Street 1:2136 GALLOWS RD STE A
Mailing Address - Street 2:
Mailing Address - City:DUNN LORING
Mailing Address - State:VA
Mailing Address - Zip Code:22027-1036
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2136 GALLOWS RD STE A
Practice Address - Street 2:
Practice Address - City:DUNN LORING
Practice Address - State:VA
Practice Address - Zip Code:22027-1036
Practice Address - Country:US
Practice Address - Phone:703-919-6753
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-08
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty