Provider Demographics
NPI:1467807867
Name:BRASSFIELD, KEITH MANNING (DC)
Entity Type:Individual
Prefix:DR
First Name:KEITH
Middle Name:MANNING
Last Name:BRASSFIELD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:552 FORT EVANS RD STE 306
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-3378
Mailing Address - Country:US
Mailing Address - Phone:703-771-3204
Mailing Address - Fax:703-771-3273
Practice Address - Street 1:552 FORT EVANS RD STE 306
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-3378
Practice Address - Country:US
Practice Address - Phone:703-771-3204
Practice Address - Fax:703-771-3204
Is Sole Proprietor?:No
Enumeration Date:2016-05-04
Last Update Date:2021-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104557272111NR0400X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
No111N00000XChiropractic ProvidersChiropractor