Provider Demographics
NPI:1972531622
Name:CAPITOL REHAB BAILEYS
Entity Type:Organization
Organization Name:CAPITOL REHAB BAILEYS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:703-671-6038
Mailing Address - Street 1:2800 10TH ST N
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22201-2174
Mailing Address - Country:US
Mailing Address - Phone:703-671-6038
Mailing Address - Fax:703-671-6048
Practice Address - Street 1:2800 10TH ST N
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22201-2174
Practice Address - Country:US
Practice Address - Phone:703-671-6038
Practice Address - Fax:703-671-6048
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-30
Last Update Date:2012-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty