Provider Demographics
NPI:1811952989
Name:CORREA-PADILLA, NYLSA A (DC)
Entity type:Individual
Prefix:
First Name:NYLSA
Middle Name:A
Last Name:CORREA-PADILLA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2678
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22555-2678
Mailing Address - Country:US
Mailing Address - Phone:540-379-8276
Mailing Address - Fax:540-720-9355
Practice Address - Street 1:556 GARRISONVILLE RD
Practice Address - Street 2:SUITE 212
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22554-7826
Practice Address - Country:US
Practice Address - Phone:540-379-8276
Practice Address - Fax:540-720-9355
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104556105111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor