Healthcare Provider Details

I. General information

NPI: 1164731337
Provider Name (Legal Business Name): WFJ PRODUCTIONS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2010
Last Update Date: 10/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9455 LORTON MARKET ST SUITE 100A
LORTON VA
22079-1962
US

IV. Provider business mailing address

PO BOX 823
LORTON VA
22199-0823
US

V. Phone/Fax

Practice location:
  • Phone: 571-286-4325
  • Fax:
Mailing address:
  • Phone: 571-286-4325
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MR. WARREN FOSTER JOHNSON III
Title or Position: PRESIDENT
Credential:
Phone: 571-286-4325