Provider Demographics
NPI:1578556270
Name:QUALITY CHIROPRACTIC
Entity Type:Organization
Organization Name:QUALITY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CAMILLE
Authorized Official - Middle Name:THERESA
Authorized Official - Last Name:D'AMATO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:703-237-0404
Mailing Address - Street 1:1440 ROSEWOOD HILL DR
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-1446
Mailing Address - Country:US
Mailing Address - Phone:703-757-9270
Mailing Address - Fax:703-757-9861
Practice Address - Street 1:6231 LEESBURG PIKE
Practice Address - Street 2:SUITE 2014
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22044-2102
Practice Address - Country:US
Practice Address - Phone:703-237-0404
Practice Address - Fax:703-237-7828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
G01446Q03Medicare ID - Type Unspecified