Organization
THE ACTIVE CHIROPRACTIC CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREGORY SCOTT PETRUZZI D.C. (OWNER)
(703) 680-3332
Entity
Organization
Contact information
Practice address
5864 MAPLEDALE PLZ, WOODBRIDGE, VA 22193-4535
(703) 680-3332
(703) 680-1365
Mailing address
5864 MAPLEDALE PLZ, WOODBRIDGE, VA 22193-4535
(703) 680-3332
(703) 680-1365
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0104556043
VA
Other
Enumeration date
03/22/2007
Last updated
08/22/2020
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