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Individual

VIVIAN K MALNIKOF

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DC

Contact information

Practice address
46169 WESTLAKE DR, SUITE 300, STERLING, VA 20165-5875
(703) 421-2990
(703) 421-2822
Mailing address
46169 WESTLAKE DR, STE 300, STERLING, VA 20165-5875
(703) 421-2990
(703) 421-2822

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0104556374
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
190001295
MEDICARE
VA
Enumeration date
12/29/2006
Last updated
01/16/2015
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