Provider Demographics
NPI:1295069623
Name:DISTRICT SPECIFIC CHIROPRACTIC LLC
Entity type:Organization
Organization Name:DISTRICT SPECIFIC CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDRINO
Authorized Official - Middle Name:DIOGENES
Authorized Official - Last Name:FLEVOTOMOS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:703-403-8984
Mailing Address - Street 1:4660 KENMORE AVE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22304-1313
Mailing Address - Country:US
Mailing Address - Phone:703-751-6006
Mailing Address - Fax:703-751-6003
Practice Address - Street 1:4660 KENMORE AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22304-1313
Practice Address - Country:US
Practice Address - Phone:703-751-6006
Practice Address - Fax:703-751-6003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-02
Last Update Date:2009-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty