Provider Demographics
NPI:1932149796
Name:URSCHEL, TARA LYNN (DC)
Entity Type:Individual
Prefix:MRS
First Name:TARA
Middle Name:LYNN
Last Name:URSCHEL
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 1:20955 PROFESSIONAL PLZ STE 320
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-3405
Mailing Address - Country:US
Mailing Address - Phone:571-918-0795
Mailing Address - Fax:571-251-2789
Practice Address - Street 1:20955 PROFESSIONAL PLZ STE 320
Practice Address - Street 2:
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-3405
Practice Address - Country:US
Practice Address - Phone:571-918-0795
Practice Address - Fax:571-251-2789
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2008-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03423111N00000X
VA0104556622111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor