Provider Demographics
NPI:1467118216
Name:DISTRICT INJURY AND SPINE CENTER
Entity Type:Organization
Organization Name:DISTRICT INJURY AND SPINE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR AND OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:POWELL
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIAU
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:732-284-1560
Mailing Address - Street 1:2001 N ADAMS ST UNIT 823
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22201-3789
Mailing Address - Country:US
Mailing Address - Phone:732-284-1560
Mailing Address - Fax:
Practice Address - Street 1:908 NEW HAMPSHIRE AVE NW STE 500
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-2352
Practice Address - Country:US
Practice Address - Phone:732-284-1560
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-15
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty