Provider Demographics
NPI:1700910684
Name:PERDZIAK, ANDREA MICHELLE (DC)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:MICHELLE
Last Name:PERDZIAK
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:MICHELLE
Other - Last Name:SARDIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:4910 31ST STREET SOUTH
Mailing Address - Street 2:B
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22206
Mailing Address - Country:US
Mailing Address - Phone:703-933-8686
Mailing Address - Fax:703-933-8779
Practice Address - Street 1:4910 31ST STREET SOUTH
Practice Address - Street 2:B
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22206
Practice Address - Country:US
Practice Address - Phone:703-933-8686
Practice Address - Fax:703-933-8779
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4293-012111N00000X
VA0104556841111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor