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NPI Code Detail

MEDICARE: ROCK RECOVERY, INC.

MEDICARE: ROCK RECOVERY, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251V00000XVoluntary or Charitable Agency

General Provider Information

NPI Number : 1104469014
Entity Type Code : Organization
Provider Name (Legal Business Name) : ROCK RECOVERY, INC.
Provider Business Mailing Address
First Line : PO BOX 100923
Second Line :
City : ARLINGTON
State : VA
Zip : 22210-3923
Country : US
Telephone Number : 712-559-9065
Fax Number :
Provider Business Practice Location Address
First Line : 1901 FORT MYER DR STE 1130
Second Line :
City : ARLINGTON
State : VA
Zip : 22209-1606
Country : US
Telephone Number : 571-255-9906
Fax Number :
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MRS. CHRISTINE DONDERO BETTWY
Credential :
Telephone Number : 571-255-9906
Provider Enumeration Date : 10/23/2019
Last Update Date : 10/23/2019

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Directions to “ROCK RECOVERY, INC. ” Practice Location

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