Sport & Spine Rehab of Sterling

NPI #1164619706 in Sterling, Virginia

Provider Information

NPI Number: 1164619706
Entity Type: Organization
Organization Name: Sport & Spine Rehab of Sterling
Primary Specialty: Chiropractor
Enumeration Date: Sep 27, 2007
Last Updated: Sep 27, 2007

Practice Location

Address: 46440 BENEDICT DR
Address 2: STE 106
City: Sterling
State: Virginia
ZIP Code: 20164-6602
Phone: (240) 766-0300

Authorized Official

Name: TAWANDA HACKLEY
Title: MANGER
Phone: (240) 766-0300

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Chiropractor	111N00000X	Primary
Chiropractor - Radiology — Radiology	111NR0200X
Chiropractor - Rehabilitation — Rehabilitation	111NR0400X

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