Provider Demographics
NPI:1710992136
Name:PATRIOT CHIROPRACTIC CENTER P.L.L.C.
Entity Type:Organization
Organization Name:PATRIOT CHIROPRACTIC CENTER P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:CURLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-385-7007
Mailing Address - Street 1:3915 OLD LEE HWY
Mailing Address - Street 2:STE 22C
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-2432
Mailing Address - Country:US
Mailing Address - Phone:703-385-7007
Mailing Address - Fax:703-385-4384
Practice Address - Street 1:3915 OLD LEE HWY
Practice Address - Street 2:STE 22C
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-2432
Practice Address - Country:US
Practice Address - Phone:703-385-7007
Practice Address - Fax:703-385-4384
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104000903111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1407841869OtherPROVIDER NPI
VA1154316511OtherPROVIDER NPI
VAG00077Medicare ID - Type UnspecifiedGROUP MEDICARE NUMBER
VAU20913Medicare UPIN
VAU20831Medicare UPIN