Provider Demographics
NPI:1861618142
Name:SAMPSON, MARTIN J (DC)
Entity type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:J
Last Name:SAMPSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36F CATOCTIN CIR SE
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20175
Mailing Address - Country:US
Mailing Address - Phone:703-777-4840
Mailing Address - Fax:703-777-7130
Practice Address - Street 1:36F CATOCTIN CIR SE
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20175
Practice Address - Country:US
Practice Address - Phone:703-777-4840
Practice Address - Fax:703-777-7130
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2010-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104000128111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor