Individual
CHETTIA PROVOST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
1240 N PITT ST, ALEXANDRIA, VA 22314-5600
(703) 739-0456
(703) 739-0032
Mailing address
1240 N PITT ST, ALEXANDRIA, VA 22314-5600
(703) 739-0456
(703) 739-0032
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0104557189
VA
Other
Enumeration date
09/11/2014
Last updated
09/11/2014
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