Provider Demographics
NPI:1457705576
Name:HOWARD CHIROPRACTIC CLINIC
Entity Type:Organization
Organization Name:HOWARD CHIROPRACTIC CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:HANNAH-QUEEN
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:703-442-0800
Mailing Address - Street 1:1980 GALLOWS RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-3913
Mailing Address - Country:US
Mailing Address - Phone:703-442-0800
Mailing Address - Fax:703-442-0808
Practice Address - Street 1:1980 GALLOWS RD
Practice Address - Street 2:SUITE 205
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-3913
Practice Address - Country:US
Practice Address - Phone:703-442-0800
Practice Address - Fax:703-442-0808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-14
Last Update Date:2016-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104557054111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty