Organization
SPORT & SPINE OF REHAB MCLEAN PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAY S GREENSTEIN DC (CEO)
(240) 766-0300
Entity
Organization
Contact information
Practice address
6845 ELM ST, STE 425, MC LEAN, VA 22101-6007
(703) 448-5799
(240) 766-0304
Mailing address
9300 LIVINGSTON RD, STE 100, FT WASHINGTON, MD 20744-4914
(240) 766-0300
(240) 766-0304
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
225100000X
Physical Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1060259
ASHN CIGNA HMO
—
01
—
2136310
MAMSI
—
01
—
3846233
AETNA HMO
—
01
—
611706800
DEPT OF LABOR
—
01
—
672723
CIGNA PPO
—
01
—
7229667
AETNA PPO
—
01
—
G746
BCBS OF NCA
—
Enumeration date
05/04/2007
Last updated
05/06/2011
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