Healthcare Provider Details

I. General information

NPI: 1811769227
Provider Name (Legal Business Name): CALVERT REJUVENATIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/30/2023
Last Update Date: 07/22/2025
Certification Date: 07/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

485 CARLISLE DR STE A
HERNDON VA
20170-5602
US

IV. Provider business mailing address

43188 SPINKS FERRY RD
LEESBURG VA
20176-5626
US

V. Phone/Fax

Practice location:
  • Phone: 571-323-1088
  • Fax:
Mailing address:
  • Phone: 571-212-2982
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: PRISCILLA CALVERT THOMPSON
Title or Position: PRESIDENT
Credential: LMT
Phone: 571-212-2982