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General NPI Number Information
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NPI Number | 1063442630
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Entity Type | Individual
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Provider Name | JON ALMQUIST ATC
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Gender | Male
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Dates
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Enumeration Date | 07/03/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 8115 GATEHOUSE RD SUITE 5100
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City | FALLS CHURCH
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State | VA
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Zip | 22042-1203
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Country | US
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Telephone | 571-423-1264
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Fax | 571-423-1267
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Provider Business Mailing Address
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Address Line | 10627 HUNTERS VALLEY RD
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City | VIENNA
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State | VA
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Zip | 22181-3019
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Country | US
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Telephone | 703-255-7163
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Fax | 571-423-1267
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 0126000155
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License Number State | VA
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