| Chosen One Therapies, Inc | |
|
10851 Tidewater Trial #103 Fredericksburg VA 22408-0260 | |
| (571) 330-8120 | |
| (877) 771-3419 |
| Full Name | Chosen One Therapies, Inc |
|---|---|
| Speciality | Specialist |
| Location | 10851 Tidewater Trial, Fredericksburg, Virginia |
| Authorized Official Name and Position | Deniece M Payne (CLINICAL DIRECTOR) |
| Authorized Official Contact | 5713308120 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Chosen One Therapies, Inc 17775 Main St Ste 104 Dumfries VA 22026-2491 Ph: (540) 693-6997 | Chosen One Therapies, Inc 10851 Tidewater Trial #103 Fredericksburg VA 22408-0260 Ph: (571) 330-8120 |
| NPI Number | 1730494329 |
|---|---|
| Provider Enumeration Date | 08/09/2010 |
| Last Update Date | 11/24/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730494329 | NPI | - | NPPES |
| 1730494329 | Medicaid | VA | |
| C10948 | Other | VA | GROUP PROVIDER (PTAN) |
| 1073788931 | Medicaid | VA |
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