Provider Demographics
NPI:1891284352
Name:HASHTROUDILAR, TINA (DC)
Entity Type:Individual
Prefix:DR
First Name:TINA
Middle Name:
Last Name:HASHTROUDILAR
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5410 BROMYARD CT
Mailing Address - Street 2:
Mailing Address - City:BURKE
Mailing Address - State:VA
Mailing Address - Zip Code:22015-1915
Mailing Address - Country:US
Mailing Address - Phone:571-218-9247
Mailing Address - Fax:
Practice Address - Street 1:9554 OLD KEENE MILL RD STE D
Practice Address - Street 2:
Practice Address - City:BURKE
Practice Address - State:VA
Practice Address - Zip Code:22015-4287
Practice Address - Country:US
Practice Address - Phone:703-372-5151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-09
Last Update Date:2018-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104-557486111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor