Provider Demographics
NPI:1609530633
Name:ALLEN, ALEXANDER LEE (DC)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:LEE
Last Name:ALLEN
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 1:13300 FRANKLIN FARM RD STE B
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20171-4096
Mailing Address - Country:US
Mailing Address - Phone:703-787-7463
Mailing Address - Fax:703-796-0516
Practice Address - Street 1:13300 FRANKLIN FARM RD STE B
Practice Address - Street 2:
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20171-4096
Practice Address - Country:US
Practice Address - Phone:703-787-7463
Practice Address - Fax:703-796-0516
Is Sole Proprietor?:No
Enumeration Date:2021-10-26
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104557770111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor