Provider Demographics
NPI:1689328155
Name:360 CHIROPRACTIC & REHAB
Entity type:Organization
Organization Name:360 CHIROPRACTIC & REHAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NATHANIEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:TREBACH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:703-507-8446
Mailing Address - Street 1:4000 FAIRFAX DR APT 701
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22203-1127
Mailing Address - Country:US
Mailing Address - Phone:703-507-8446
Mailing Address - Fax:
Practice Address - Street 1:4000 FAIRFAX DR APT 701
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22203-1127
Practice Address - Country:US
Practice Address - Phone:703-507-8446
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-03
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty