Provider Demographics
NPI:1619091667
Name:LANSDOWNE FAMILY CHIROPRACTIC CENTER INC.
Entity Type:Organization
Organization Name:LANSDOWNE FAMILY CHIROPRACTIC CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:DUKE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:703-723-4333
Mailing Address - Street 1:19465 DEERFIELD AVE
Mailing Address - Street 2:SUITE 108
Mailing Address - City:LANSDOWNE
Mailing Address - State:VA
Mailing Address - Zip Code:20176-8446
Mailing Address - Country:US
Mailing Address - Phone:703-723-4333
Mailing Address - Fax:703-723-4343
Practice Address - Street 1:19465 DEERFIELD AVE
Practice Address - Street 2:SUITE 108
Practice Address - City:LANSDOWNE
Practice Address - State:VA
Practice Address - Zip Code:20176-8446
Practice Address - Country:US
Practice Address - Phone:703-723-4333
Practice Address - Fax:703-723-4343
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104555588111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0300292Medicaid
VA100511OtherASHN AETNA HMO
VA265563OtherANTHEM BCBS
VA1005511OtherASHN CIGNA HMO
VA1682306OtherCIGNA PPO
VAF4520001OtherCAREFIRST BCBS
VA629474OtherUNITED HEALTHCARE
VA7899141OtherAETNA PPO(NON HMO)
VA=========OtherUNICARE
VA0300292Medicaid
VA100511OtherASHN AETNA HMO
VA7899141OtherAETNA PPO(NON HMO)