Fairfax Chiropractic and Wellness Center LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

FAIRFAX CHIROPRACTIC AND WELLNESS CENTER LLC

Practice address

10640 Main St Ste 103
Fairfax, VA 22030-3930

Phone

(703) 291-6677

Fax

(703) 352-8935

NPI assigned

Sep 29, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Benjamin N Glasman, D.C

Title

Owner of Entity

Phone

(703) 291-6677

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1632873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632873600000",
    "number": "1417629387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10640 MAIN ST STE 103",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220303930",
            "telephone_number": "703-291-6677",
            "fax_number": "703-352-8935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10640 MAIN ST STE 103",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220303930",
            "telephone_number": "703-291-6677",
            "fax_number": "703-352-8935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRFAX CHIROPRACTIC AND WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-29",
        "last_updated": "2021-09-29",
        "certification_date": "2021-09-29",
        "status": "A",
        "authorized_official_last_name": "GLASMAN",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER OF ENTITY",
        "authorized_official_telephone_number": "703-291-6677",
        "authorized_official_credential": "D.C"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Chiropractor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.