Provider Demographics
NPI:1215174339
Name:VITALCARE BODY TREATMENT SOLUTIONS, PLC
Entity type:Organization
Organization Name:VITALCARE BODY TREATMENT SOLUTIONS, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:MCNALLY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:703-481-1616
Mailing Address - Street 1:435 CARLISLE DR STE A
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20170-4802
Mailing Address - Country:US
Mailing Address - Phone:703-481-1616
Mailing Address - Fax:703-481-3474
Practice Address - Street 1:435 CARLISLE DR STE A
Practice Address - Street 2:
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20170-4802
Practice Address - Country:US
Practice Address - Phone:703-481-1616
Practice Address - Fax:703-481-3474
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-12
Last Update Date:2009-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104000569111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty