Provider Demographics
NPI:1700049871
Name:HERNDON CHIROPRACTIC & ACUPUNCTURE CARE, PC
Entity Type:Organization
Organization Name:HERNDON CHIROPRACTIC & ACUPUNCTURE CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GURUTRANG
Authorized Official - Middle Name:SINGH
Authorized Official - Last Name:KHALSA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:703-481-9000
Mailing Address - Street 1:694 PINE ST
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20170-4600
Mailing Address - Country:US
Mailing Address - Phone:703-481-9000
Mailing Address - Fax:703-481-9003
Practice Address - Street 1:694 PINE ST
Practice Address - Street 2:
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20170-4600
Practice Address - Country:US
Practice Address - Phone:703-481-9000
Practice Address - Fax:703-481-9003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-08
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104000299111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NI0900XChiropractic ProvidersChiropractorInternistGroup - Single Specialty