Healthcare Provider Details

I. General information

NPI: 1922814227
Provider Name (Legal Business Name): ZEN AESTHETICS MEDSPA & WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2024
Last Update Date: 12/10/2024
Certification Date: 12/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8420 DORSEY CIR STE 201
MANASSAS VA
20110-8300
US

IV. Provider business mailing address

9201 MACKENZIE MEADOW CT
NOKESVILLE VA
20181-1031
US

V. Phone/Fax

Practice location:
  • Phone: 703-615-4591
  • Fax:
Mailing address:
  • Phone: 703-615-4591
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SAEED AMIRI
Title or Position: OFFICER
Credential: DC
Phone: 703-615-4591