Provider Demographics
NPI:1891274411
Name:TOTAL PERFORMANCE CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:TOTAL PERFORMANCE CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:KATHRYN
Authorized Official - Last Name:SCHAFER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:703-309-1231
Mailing Address - Street 1:8245 BOONE BLVD STE 110
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-3813
Mailing Address - Country:US
Mailing Address - Phone:703-356-8721
Mailing Address - Fax:703-356-8722
Practice Address - Street 1:8245 BOONE BLVD STE 110
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-3813
Practice Address - Country:US
Practice Address - Phone:703-356-8721
Practice Address - Fax:703-356-8722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-14
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty