Organization
COYOTE CHIROPRACTIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDALL E WILEY DC (PRESIDENT OWNER)
(703) 242-3533
Entity
Organization
Contact information
Practice address
320 MAPLE AVE E, SUITE C, VIENNA, VA 22180-4716
(703) 242-3533
(703) 242-3541
Mailing address
320 MAPLE AVE E, SUITE C, VIENNA, VA 22180-4716
(703) 242-3533
(703) 242-3541
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0104556249
VA
Other
Enumeration date
08/31/2006
Last updated
04/20/2008
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