| Axiom Health Corporation | |
|
9707 Signal Ct Manassas VA 20111-2505 | |
| (703) 459-4773 | |
| Not Available |
| Full Name | Axiom Health Corporation |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 9707 Signal Ct, Manassas, Virginia |
| Authorized Official Name and Position | Marina Susana Abad (CEO) |
| Authorized Official Contact | 7034594773 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Axiom Health Corporation 9707 Signal Ct Manassas VA 20111-2505 Ph: (703) 459-4773 | Axiom Health Corporation 9707 Signal Ct Manassas VA 20111-2505 Ph: (703) 459-4773 |
| NPI Number | 1700129194 |
|---|---|
| Provider Enumeration Date | 04/03/2013 |
| Last Update Date | 03/07/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700129194 | NPI | - | NPPES |
| 0024167755 | Other | VA | BOARD OF NURSING, NURSE PRACTITIONER LICENSE |
| 1912174855 | Other | VA | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 0024167755 (Virginia) | Primary |
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