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Individual

DR. BRUCE J SHORT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
19945 RIVERSIDE COMMONS PLZ STE 100, ASHBURN, VA 20147-5146
(703) 481-4400
(703) 935-0430
Mailing address
18328 BUCCANEER TER, LEESBURG, VA 20176-8474
(703) 400-5868
(703) 935-0430

Taxonomy

Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
0104555886
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
F964-0001
CAREFIRST BC/BS
DC
Enumeration date
07/31/2006
Last updated
11/12/2025
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