Individual
KERRY A EGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
4200 MOZART BRIGADE LN APT E, FAIRFAX, VA 22033-3971
(703) 473-4145
Mailing address
4200 MOZART BRIGADE LN APT E, FAIRFAX, VA 22033-3971
(703) 473-4145
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0104556828
VA
111N00000X
Chiropractor
038010776
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2232480
BCBS GROUP NUMBER
IL
Enumeration date
11/06/2006
Last updated
03/19/2014
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