Provider Demographics
NPI:1578816047
Name:TRIANDOS CHIROPRACTIC
Entity Type:Organization
Organization Name:TRIANDOS CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:NICK
Authorized Official - Middle Name:
Authorized Official - Last Name:TRIANDOS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:703-548-5600
Mailing Address - Street 1:312 S WASHINGTON ST
Mailing Address - Street 2:#4D
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-3684
Mailing Address - Country:US
Mailing Address - Phone:703-548-5600
Mailing Address - Fax:
Practice Address - Street 1:312 S WASHINGTON ST
Practice Address - Street 2:#4D
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-3684
Practice Address - Country:US
Practice Address - Phone:703-548-5600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-22
Last Update Date:2012-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104001977111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA490176Medicare PIN