Provider Demographics
NPI:1013143148
Name:INGRAM, DAVID JR (DC)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:INGRAM
Suffix:JR
Gender:M
Credentials:DC
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:14215B CENTREVILLE SQ
Mailing Address - Street 2:CHIROPRACTIC FAMILY HEALTH CENTRE
Mailing Address - City:CENTREVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20121-2301
Mailing Address - Country:US
Mailing Address - Phone:703-222-3737
Mailing Address - Fax:703-449-9346
Practice Address - Street 1:14215B CENTREVILLE SQ
Practice Address - Street 2:CHIROPRACTIC FAMILY HEALTH CENTRE
Practice Address - City:CENTREVILLE
Practice Address - State:VA
Practice Address - Zip Code:20121-2301
Practice Address - Country:US
Practice Address - Phone:703-222-3737
Practice Address - Fax:703-449-9346
Is Sole Proprietor?:No
Enumeration Date:2009-06-03
Last Update Date:2009-06-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0104556573111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor