Healthcare Provider Details

I. General information

NPI: 1497233944
Provider Name (Legal Business Name): ADFINITAS REHABILITATIVE SERVICES OF VIRGINIA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2018
Last Update Date: 08/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 HOSPITAL DR
WARRENTON VA
20186-3006
US

IV. Provider business mailing address

7250 PARKWAY DR
HANOVER MD
21076-1388
US

V. Phone/Fax

Practice location:
  • Phone: 443-949-0814
  • Fax:
Mailing address:
  • Phone: 443-949-0814
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MONICA WRIGHT
Title or Position: DIRECTOR OF REVENUE CYCLE MANAGEMEN
Credential:
Phone: 443-949-0814