| Fortify Chiropractic And Sports Rehab | |
|
43130 Amberwood Plz Ste 105, Chantilly, VA 20152-4106 | |
| (703) 755-0545 | |
| (703) 991-9179 |
| Full Name | Fortify Chiropractic And Sports Rehab |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 43130 Amberwood Plz Ste 105, Chantilly, Virginia |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346987450 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | (* (Not Available)) | Primary |
| Provider Name | Christopher Grivas |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1184140501 PECOS PAC ID: 0345633954 Enrollment ID: I20220624001863 |
| Mailing Address | Practice Location Address |
|---|---|
| Fortify Chiropractic And Sports Rehab 43130 Amberwood Plz Ste 105, Chantilly, VA 20152-4106 Ph: (703) 755-0545 | Fortify Chiropractic And Sports Rehab 43130 Amberwood Plz Ste 105, Chantilly, VA 20152-4106 Ph: (703) 755-0545 |
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