Provider Demographics
NPI:1568682128
Name:DR SARAH H PETERSON DC PLC
Entity Type:Organization
Organization Name:DR SARAH H PETERSON DC PLC
Other - Org Name:LANDMARK CHIROPRACTIC & PT CLINIC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CHIROPRACTOR OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:HATAM
Authorized Official - Last Name:PETERSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:703-370-5300
Mailing Address - Street 1:5249 DUKE ST
Mailing Address - Street 2:#205
Mailing Address - City:ALEX
Mailing Address - State:VA
Mailing Address - Zip Code:22304
Mailing Address - Country:US
Mailing Address - Phone:703-370-5300
Mailing Address - Fax:703-367-7878
Practice Address - Street 1:5249 DUKE ST
Practice Address - Street 2:#205
Practice Address - City:ALEX
Practice Address - State:VA
Practice Address - Zip Code:22304
Practice Address - Country:US
Practice Address - Phone:703-370-5300
Practice Address - Fax:703-367-7878
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104001683111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty