Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 0104556259 | VA |
N | 111NX0100X | Occupational Health | 0104556259 | VA |
NPI | 1093743080 |
---|---|
Provider Name | Mr. Brian Joseph Tenshaw |
First Address | Oakton, VA 22124-3000 |
Second Address | Oakton, VA 22124-3000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
174814 | ANTHEM BC/BS (01) | VA |
7049650 | AETNA (01) | VA |
708668 | NCPPO (01) | VA |
F172-0002 | CAREFIRST BC/BS (01) | VA |