Provider Demographics
NPI:1861805889
Name:PURE MOVEMENT CHIROPRACTIC, PLLC
Entity type:Organization
Organization Name:PURE MOVEMENT CHIROPRACTIC, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LEANNA
Authorized Official - Middle Name:R
Authorized Official - Last Name:LEMASTER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:703-707-0048
Mailing Address - Street 1:150 ELDEN ST STE 423
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20170-4861
Mailing Address - Country:US
Mailing Address - Phone:703-707-0048
Mailing Address - Fax:703-481-1806
Practice Address - Street 1:150 ELDEN ST STE 423
Practice Address - Street 2:
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20170-4861
Practice Address - Country:US
Practice Address - Phone:703-707-0048
Practice Address - Fax:703-481-1806
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-06
Last Update Date:2014-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104557177111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty