Provider Demographics
NPI:1871593327
Name:MISRA, BIBHU R (DC, MSC)
Entity type:Individual
Prefix:DR
First Name:BIBHU
Middle Name:R
Last Name:MISRA
Suffix:
Gender:M
Credentials:DC, MSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21785 FILIGREE CT STE 200
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-6214
Mailing Address - Country:US
Mailing Address - Phone:703-724-9899
Mailing Address - Fax:703-724-9897
Practice Address - Street 1:21785 FILIGREE CT
Practice Address - Street 2:SUITE 200
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-6213
Practice Address - Country:US
Practice Address - Phone:703-724-9899
Practice Address - Fax:703-724-9897
Is Sole Proprietor?:No
Enumeration Date:2005-07-27
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104556248111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor