Provider Demographics
NPI:1780725341
Name:FAMILY CHIROPRACTIC OF SPRINGFIELD INC
Entity type:Organization
Organization Name:FAMILY CHIROPRACTIC OF SPRINGFIELD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MOJGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:JAMASI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-569-1300
Mailing Address - Street 1:8440 OLD KEENE MILL RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22152-2302
Mailing Address - Country:US
Mailing Address - Phone:703-569-1300
Mailing Address - Fax:703-569-1972
Practice Address - Street 1:8440 OLD KEENE MILL RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22152-2302
Practice Address - Country:US
Practice Address - Phone:703-569-1300
Practice Address - Fax:703-569-1972
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
428735MD2OtherM.D. IPA HEALTH PLAN
VA0040839OtherHUMANA
VA119986OtherANTHEM BCBS
4287350C2OtherOPTIMUM CHOICE, INC.
428735ML2OtherMAMSI LIFE & HEALTH INS C
2364351OtherAETNA
346244PPOOtherNCPPO
428735ML2OtherMAMSI LIFE & HEALTH INS C
G00389Medicare ID - Type Unspecified