Provider Demographics
NPI:1497824296
Name:NORTHERN VIRGINIA PAIN AND REHAB CENTER, PC
Entity Type:Organization
Organization Name:NORTHERN VIRGINIA PAIN AND REHAB CENTER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:KARLA
Authorized Official - Middle Name:M
Authorized Official - Last Name:HERAUD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-535-8887
Mailing Address - Street 1:2955 S GLEBE RD
Mailing Address - Street 2:SUITE E
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22206-2730
Mailing Address - Country:US
Mailing Address - Phone:703-535-8887
Mailing Address - Fax:703-535-7819
Practice Address - Street 1:2955 S GLEBE RD
Practice Address - Street 2:SUITE E
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22206-2730
Practice Address - Country:US
Practice Address - Phone:703-535-8887
Practice Address - Fax:703-535-7819
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty