Provider Demographics
NPI:1861126724
Name:RIVERA SANCHEZ, HIRAM BJ (DC)
Entity type:Individual
Prefix:DR
First Name:HIRAM
Middle Name:BJ
Last Name:RIVERA SANCHEZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:HIRAM
Other - Middle Name:BJ
Other - Last Name:RIVERA SANCHEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:4847 W BRADDOCK RD APT 101
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22311-4851
Mailing Address - Country:US
Mailing Address - Phone:787-346-2022
Mailing Address - Fax:
Practice Address - Street 1:50 S PICKETT ST STE 201
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22304-7208
Practice Address - Country:US
Practice Address - Phone:703-678-9726
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-14
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104557797111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty