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22980 Indian Creek Dr Ste 300 Sterling VA 20166 | |
| (571) 370-3644 | |
| (571) 789-2214 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 22980 Indian Creek Dr Ste 300, Sterling, Virginia |
| Authorized Official Name and Position | Jon Leizman (PRESIDENT) |
| Authorized Official Contact | 2164799063 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
5500 Maryland Way Ste 120 Brentwood TN 37027-4993 Ph: () - | 22980 Indian Creek Dr Ste 300 Sterling VA 20166 Ph: (571) 370-3644 |
| NPI Number | 1417227083 |
|---|---|
| Provider Enumeration Date | 01/12/2012 |
| Last Update Date | 08/15/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417227083 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| 261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Secondary |
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