| Amanda Lynn Nutrition Llc | |
|
9031 Endicott Pl Lorton VA 22079-4541 | |
| (815) 321-1555 | |
| Not Available |
| Full Name | Amanda Lynn Nutrition Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 9031 Endicott Pl, Lorton, Virginia |
| Authorized Official Name and Position | Amanda Lynn Stathos (OWNER) |
| Authorized Official Contact | 8153211555 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Amanda Lynn Nutrition Llc 9031 Endicott Pl Lorton VA 22079-4541 Ph: (815) 321-1555 | Amanda Lynn Nutrition Llc 9031 Endicott Pl Lorton VA 22079-4541 Ph: (815) 321-1555 |
| NPI Number | 1407578511 |
|---|---|
| Provider Enumeration Date | 09/15/2022 |
| Last Update Date | 09/15/2022 |
| Medicare PECOS PAC ID | 5092186197 |
|---|---|
| Medicare Enrollment ID | O20230128000125 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407578511 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Amanda Lynn Stathos |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1144869678 PECOS PAC ID: 6901277003 Enrollment ID: I20230128000161 |
Infectious Diseases Associates Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 8988 Lorton Station Blvd, #204, Lorton, VA 22079 Phone: 703-339-3524 Fax: 703-339-9157 | |
Lorton Station Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8988 Lorton Station Blvd, Suite 201, Lorton, VA 22079 Phone: 703-339-7550 Fax: 703-339-7553 | |
Baseline Financial Management Group Corp Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7217 Lockport Pl, Suite 102, Lorton, VA 22079 Phone: 703-548-1555 | |
Medstar Georgetown Ortho Inst Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 9455 Lorton Market St, Ste 200, Lorton, VA 22079 Phone: 703-971-3701 Fax: 703-339-6351 | |
Lorton Primary Care Plc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7740 Gunston Plz, Lorton, VA 22079 Phone: 703-339-5858 Fax: 703-339-5860 | |
Williamsburg Square Family Practice,p.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 9500 Richmond Hwy, Lorton, VA 22079 Phone: 703-339-7788 |