Provider Demographics
NPI:1790456085
Name:TRAXLER, DAN (DC)
Entity Type:Individual
Prefix:
First Name:DAN
Middle Name:
Last Name:TRAXLER
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 1:6 PIDGEON HILL DR STE 150
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20165-6146
Mailing Address - Country:US
Mailing Address - Phone:703-634-6500
Mailing Address - Fax:
Practice Address - Street 1:6 PIDGEON HILL DR STE 150
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20165-6146
Practice Address - Country:US
Practice Address - Phone:703-634-6500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-26
Last Update Date:2021-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104557566111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0104557566OtherVA CHIROPRACTIC LICENSING BOARD