Healthcare Provider Details

I. General information

NPI: 1609302066
Provider Name (Legal Business Name): FOXCARE INTEGRATIVE HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2017
Last Update Date: 05/05/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1410 ROLKIN CT SUITE 201
CHARLOTTESVILLE VA
22911-3587
US

IV. Provider business mailing address

224D CORNWALL ST NW SUITE 403
LEESBURG VA
20176-2700
US

V. Phone/Fax

Practice location:
  • Phone: 703-421-7000
  • Fax: 703-430-4830
Mailing address:
  • Phone: 703-737-6001
  • Fax: 703-443-8643

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: REBECCA FOX
Title or Position: PRESIDENT
Credential:
Phone: 703-421-7000