Healthcare Provider Details

I. General information

NPI: 1700798311
Provider Name (Legal Business Name): SEEK REGENERATIVE WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8389 SUDLEY RD # 111
MANASSAS VA
20109-3508
US

IV. Provider business mailing address

8389 SUDLEY RD # 111
MANASSAS VA
20109-3508
US

V. Phone/Fax

Practice location:
  • Phone: 571-361-9089
  • Fax:
Mailing address:
  • Phone: 571-361-9089
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: SHRYLOCJ LUMBAO
Title or Position: PROVIDER
Credential: NP
Phone: 571-361-9089