Provider Demographics
NPI:1720306079
Name:DC INJURY CENTER,LLC
Entity Type:Organization
Organization Name:DC INJURY CENTER,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NESLY
Authorized Official - Middle Name:
Authorized Official - Last Name:CLERGE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:202-546-7246
Mailing Address - Street 1:400 8TH ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-5228
Mailing Address - Country:US
Mailing Address - Phone:202-546-7246
Mailing Address - Fax:
Practice Address - Street 1:400 8TH ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-5228
Practice Address - Country:US
Practice Address - Phone:202-546-7246
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-11
Last Update Date:2010-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCCH030059111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty