| Virginia Functional Medicine, Inc | |
|
410 Pine St Se Suite 320 Vienna VA 22180-4861 | |
| (703) 938-1421 | |
| (703) 938-1424 |
| Full Name | Virginia Functional Medicine, Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 410 Pine St Se, Vienna, Virginia |
| Authorized Official Name and Position | Kaj O Christensen (VP) |
| Authorized Official Contact | 7039381421 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Virginia Functional Medicine, Inc 410 Pine St Se Suite 320 Vienna VA 22180-4861 Ph: (703) 938-1421 | Virginia Functional Medicine, Inc 410 Pine St Se Suite 320 Vienna VA 22180-4861 Ph: (703) 938-1421 |
| NPI Number | 1194011783 |
|---|---|
| Provider Enumeration Date | 06/22/2011 |
| Last Update Date | 01/18/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194011783 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 0101249229 (Virginia) | Primary |
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