Provider Demographics
NPI:1770600256
Name:ALTERNATIVE CARE CHIROPRACTIC & REHABILITATION CENTER INC
Entity type:Organization
Organization Name:ALTERNATIVE CARE CHIROPRACTIC & REHABILITATION CENTER INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:BRUNO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:703-904-8230
Mailing Address - Street 1:1810 MICHAEL FARADAY DR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20190-5353
Mailing Address - Country:US
Mailing Address - Phone:571-375-0610
Mailing Address - Fax:703-662-6249
Practice Address - Street 1:1810 MICHAEL FARADAY DR
Practice Address - Street 2:SUITE 202
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-5353
Practice Address - Country:US
Practice Address - Phone:571-375-0610
Practice Address - Fax:703-662-6249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2014-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104001057111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VABR790429Medicare ID - Type Unspecified
VA790429Medicare UPIN