Tysons Therapeutics Pllc | |
8320 Old Courthouse Rd Suite 400 Vienna VA 22182-3831 | |
(703) 226-4005 | |
(703) 226-4020 |
Full Name | Tysons Therapeutics Pllc |
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Speciality | Clinic/Center |
Location | 8320 Old Courthouse Rd, Vienna, Virginia |
Authorized Official Name and Position | Heidi Jo Crayton (MEDICAL DIRECTOR) |
Authorized Official Contact | 7032264005 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Tysons Therapeutics Pllc 8320 Old Courthouse Rd Suite 400 Vienna VA 22182-3831 Ph: (703) 226-4005 | Tysons Therapeutics Pllc 8320 Old Courthouse Rd Suite 400 Vienna VA 22182-3831 Ph: (703) 226-4005 |
NPI Number | 1295886034 |
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Provider Enumeration Date | 01/16/2007 |
Last Update Date | 03/05/2008 |
Medicare PECOS PAC ID | 5395843577 |
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Medicare Enrollment ID | O20070612000406 |
Identifier | Type | State | Issuer |
---|---|---|---|
1295886034 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | 0101056335 (Virginia) | Primary |
Provider Name | Heidi J Crayton |
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Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1669470720 PECOS PAC ID: 9931207115 Enrollment ID: I20070612000422 |
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