Organization
PEPPERWOLF SPINAL CARE INSTITUTE LLC
Active
Parent organization
PEPPERWOLF SPINAL CARE INSTITUTE LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PEPPERWOLF SPINAL CARE INSTITUTE LLC
Authorized official
DR. BRAD A WOLF D.C. (PRESIDENT)
(703) 204-2320
Entity
Organization
Contact information
Practice address
2136 GALLOWS ROAD, SUITE A, DUNN LORING, VA 22027-1036
(703) 204-2320
(703) 204-1618
Mailing address
2136 GALLOWS ROAD, SUITE A, DUNN LORING, VA 22027-1036
(703) 204-2320
(703) 204-1618
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1747
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
256800
BLUE CROSS BLUE SHIELD
VA
Enumeration date
05/27/2006
Last updated
03/15/2011
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