Provider Demographics
NPI:1720406929
Name:FREY, ASA REUBEN (DC)
Entity Type:Individual
Prefix:DR
First Name:ASA
Middle Name:REUBEN
Last Name:FREY
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 1:9526B LEE HWY
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-2303
Mailing Address - Country:US
Mailing Address - Phone:703-385-2990
Mailing Address - Fax:703-385-1657
Practice Address - Street 1:9526B LEE HWY
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-2303
Practice Address - Country:US
Practice Address - Phone:703-385-2990
Practice Address - Fax:703-385-1657
Is Sole Proprietor?:No
Enumeration Date:2014-04-03
Last Update Date:2014-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104557157111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor