Healthcare Provider Details

I. General information

NPI: 1649810805
Provider Name (Legal Business Name): ANDERSON CLINIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2020
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3299 WOODBURN RD STE 480
ANNANDALE VA
22003-7333
US

IV. Provider business mailing address

2800 S SHIRLINGTON RD STE 1100
ARLINGTON VA
22206-3605
US

V. Phone/Fax

Practice location:
  • Phone: 703-892-6500
  • Fax: 703-521-3415
Mailing address:
  • Phone: 703-892-6500
  • Fax: 703-521-3415

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State

VIII. Authorized Official

Name: BETSY CHAPPELL
Title or Position: CFO
Credential:
Phone: 703-892-6500