Provider Demographics
NPI:1275780959
Name:MUZINSKI, KIMBERLY RENEE' (DC)
Entity type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:RENEE'
Last Name:MUZINSKI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:KIMBERLY
Other - Middle Name:RENEE'
Other - Last Name:PHELPS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:5610 LEE HWY
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22207-1445
Mailing Address - Country:US
Mailing Address - Phone:703-237-5999
Mailing Address - Fax:703-532-1172
Practice Address - Street 1:5610 LEE HWY
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22207-1445
Practice Address - Country:US
Practice Address - Phone:703-237-5999
Practice Address - Fax:703-532-1172
Is Sole Proprietor?:No
Enumeration Date:2008-08-25
Last Update Date:2009-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104001037111N00000X
MO005734111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAT86410Medicare UPIN
VA31330Medicare PIN