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SPORT AND SPINE REHAB OF FAIRFAX NPI 1174735856


NPI Information

NPI: 1174735856
Provider Name: SPORT AND SPINE REHAB OF FAIRFAX
Classification: Chiropractor - 111N00000X
Entity Type: Organization
Address:
10807 MAIN STREET
FAIRFAX, VA
ZIP 22303
Phone: (703) 890-2222
Get Directions

SPORT AND SPINE REHAB OF FAIRFAX is a chiropractor in Fairfax, VA. The provider is a provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. SPORT AND SPINE REHAB OF FAIRFAX NPI is 1174735856. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

10807 MAIN STREET
FAIRFAX, VA
ZIP 22303
Phone: (703) 890-2222

The provider's authorized official is Jay Greenstein .
The authorized official title is Ceo and has the following contact phone number (240) 766-0300.

The enumeration date for this NPI number is 5/4/2007 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1111N00000XChiropractorYes
2225100000XPhysical TherapistX

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11066011OTHERAETNA HMO
22159023OTHERALLIANCE
307950876OTHERAETNA PPO
4K218OTHERBCBS OF NCA
520994125OTHERPHCS
6196849OTHERANTHEM
72159023OTHERMAMSI MDIPA OPTIMUM CHOIC
81066011OTHERASHN CIGNA HMO
9698870OTHERCIGNA PPO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.