Provider Demographics
NPI:1679763429
Name:ALEXANDER CHIROPRACTIC NEUROLOGY CENTER
Entity Type:Organization
Organization Name:ALEXANDER CHIROPRACTIC NEUROLOGY CENTER
Other - Org Name:ALEXANDER CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:ALEXANDER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:703-689-0762
Mailing Address - Street 1:462 HERNDON PARKWAY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20170-5234
Mailing Address - Country:US
Mailing Address - Phone:703-689-0762
Mailing Address - Fax:703-689-0920
Practice Address - Street 1:462 HERNDON PKWY
Practice Address - Street 2:SUITE 101
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20170-5234
Practice Address - Country:US
Practice Address - Phone:703-689-0762
Practice Address - Fax:703-689-0920
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-27
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104000784111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty