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General NPI Number Information
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NPI Number | 1043441223
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Entity Type | Organization
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Legal Business Name | PHYSICIANS HEALTH SOLUTIONS
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Dates
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Enumeration Date | 08/05/2009
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Last Update Date | 09/14/2011
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Provider Practice Location Address
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Address Line | 44035 RIVERSIDE PKWY 345
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City | LEESBURG
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State | VA
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Zip | 20176-8260
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Country | US
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Telephone | 703-466-0455
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Fax | 703-726-0044
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Provider Business Mailing Address
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Address Line | 44035 RIVERSIDE PKWY 345
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City | LEESBURG
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State | VA
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Zip | 20176-8260
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Country | US
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Telephone | 703-466-0455
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Fax | 703-726-0044
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Authorized Official
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Title or Position | CHIEF PHYSICIAN OFFICER/PODIATRIST
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Name | DR. TASHA LATRICE YOUNG
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Credential | DPM
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Telephone | 703-466-0455
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 0104556539
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | 0103300977
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License Number State | VA
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