Provider Demographics
NPI:1902149065
Name:BACKUS, ADRIANA N (DC)
Entity Type:Individual
Prefix:DR
First Name:ADRIANA
Middle Name:N
Last Name:BACKUS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6862 ELM ST STE 600
Mailing Address - Street 2:
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-3862
Mailing Address - Country:US
Mailing Address - Phone:202-674-0644
Mailing Address - Fax:
Practice Address - Street 1:6862 ELM ST STE 600
Practice Address - Street 2:
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-3862
Practice Address - Country:US
Practice Address - Phone:202-674-0644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-27
Last Update Date:2013-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104557057111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor