Healthcare Provider Details

I. General information

NPI: 1619807534
Provider Name (Legal Business Name): NOVA THERAPEUTIC MASSAGE LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2250 CLARENDON BLVD STE K
ARLINGTON VA
22201-3349
US

IV. Provider business mailing address

2250 CLARENDON BLVD
ARLINGTON VA
22201-3332
US

V. Phone/Fax

Practice location:
  • Phone: 703-816-8811
  • Fax:
Mailing address:
  • Phone: 202-374-1850
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: NAN DAVISON
Title or Position: OWNER
Credential: LMT
Phone: 703-816-8811