| |
5130 Duke St Ste 114, Alexandria, VA 22304-2924 | |
(703) 370-5300 | |
(703) 370-0080 |
Full Name | |
---|---|
Type | Facility |
Speciality | Nurse Practitioner |
Location | 5130 Duke St Ste 114, Alexandria, Virginia |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1780840413 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | (* (Not Available)) | Secondary |
363L00000X | Nurse Practitioner | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
---|---|
344 Maple Ave West, 231, Vienna, VA 22180 Ph: (703) 370-5300 | 5130 Duke St Ste 114, Alexandria, VA 22304-2924 Ph: (703) 370-5300 |