Greater Loudoun Chiropractic & Wellness Center PC

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

0104000954 Issued in VA

Legal business name

GREATER LOUDOUN CHIROPRACTIC & WELLNESS CENTER PC

Practice address

17337 Pickwick Dr Ste B
Purcellville, VA 20132-6176

Phone

(540) 338-0005

Fax

(540) 338-0966

NPI assigned

Aug 14, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Guy M Fanelli, D.C., C.C.S.P.

Title

Owner

Phone

(540) 338-0005

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1250208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1250208000000",
    "number": "1497987184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17337 PICKWICK DR STE B",
            "city": "PURCELLVILLE",
            "state": "VA",
            "postal_code": "201326176",
            "telephone_number": "540-338-0005",
            "fax_number": "540-338-0966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17337 PICKWICK DR STE B",
            "city": "PURCELLVILLE",
            "state": "VA",
            "postal_code": "201326176",
            "telephone_number": "540-338-0005",
            "fax_number": "540-338-0966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER LOUDOUN CHIROPRACTIC & WELLNESS CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-14",
        "last_updated": "2009-08-14",
        "status": "A",
        "authorized_official_last_name": "FANELLI",
        "authorized_official_first_name": "GUY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "540-338-0005",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C., C.C.S.P."
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": "VA",
            "license": "0104000954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sports Physician Chiropractor in Purcellville, VA
• Providers in Purcellville, VA by specialty
• Sports Physician Chiropractor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2009; 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.