Provider Demographics
NPI:1548297484
Name:FAMILY CHIROPRACTIC CENTER OF OAKTON, PC
Entity type:Organization
Organization Name:FAMILY CHIROPRACTIC CENTER OF OAKTON, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:TENSHAW
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:703-938-7555
Mailing Address - Street 1:2972 CHAIN BRIDGE RD STE F
Mailing Address - Street 2:
Mailing Address - City:OAKTON
Mailing Address - State:VA
Mailing Address - Zip Code:22124-3000
Mailing Address - Country:US
Mailing Address - Phone:703-938-7555
Mailing Address - Fax:703-938-3752
Practice Address - Street 1:2972 CHAIN BRIDGE RD STE F
Practice Address - Street 2:
Practice Address - City:OAKTON
Practice Address - State:VA
Practice Address - Zip Code:22124-3000
Practice Address - Country:US
Practice Address - Phone:703-938-7555
Practice Address - Fax:703-938-3752
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104556259111NX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NX0100XChiropractic ProvidersChiropractorOccupational HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA174814OtherANTHEM BC/BS
VAF172-0002OtherCAREFIRST BC/BS
VA708668OtherNCPPO
VA653920OtherUNITED HEALTH CARE
VA7049650OtherAETNA
VAF172-0002OtherCAREFIRST BC/BS