Organization
ACTIVE FAMILY CHIROPARCTIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BLANCA L QUINTANILLA (INSURANCE MANAGER)
(703) 689-3500
Entity
Organization
Contact information
Practice address
11790 BARON CAMERON AVE STE J, RESTON, VA 20190-5873
(703) 689-3500
(703) 689-3500
Mailing address
11790 BARON CAMERON AVE STE J, RESTON, VA 20190-5873
(703) 689-3500
(703) 689-3500
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Enumeration date
05/27/2008
Last updated
09/26/2008
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