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General NPI Number Information
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NPI Number | 1144124215
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Entity Type | Individual
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Provider Name | LIAM ALEXANDER LOCKHART NIMICK
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Gender | Male
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Dates
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Enumeration Date | 10/05/2026
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Last Update Date | 10/05/2026
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Provider Practice Location Address
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Address Line | 6134R ARLINGTON BLVD STE 111
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City | FALLS CHURCH
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State | VA
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Zip | 22044-2901
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Country | US
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Telephone | 703-930-3801
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Fax |
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Provider Business Mailing Address
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Address Line | 2311 PIMMIT DR APT 101
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City | FALLS CHURCH
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State | VA
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Zip | 22043-2800
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Country | US
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Telephone | 703-650-8175
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Fax |
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 0019018065
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License Number State | VA
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