Provider Demographics
NPI:1043535156
Name:ARGEN, EDMOND GERARD (DC)
Entity type:Individual
Prefix:
First Name:EDMOND
Middle Name:GERARD
Last Name:ARGEN
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 1:3970 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-4726
Mailing Address - Country:US
Mailing Address - Phone:703-352-4357
Mailing Address - Fax:703-352-8935
Practice Address - Street 1:3970 WALNUT ST
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-4726
Practice Address - Country:US
Practice Address - Phone:703-352-4357
Practice Address - Fax:703-352-8935
Is Sole Proprietor?:No
Enumeration Date:2010-03-31
Last Update Date:2010-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104000838111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor