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General NPI Number Information
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NPI Number | 1154020428
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Entity Type | Organization
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Legal Business Name | REACH SPECIALTIES, PLLC
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Dates
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Enumeration Date | 02/27/2023
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Last Update Date | 02/28/2023
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Provider Practice Location Address
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Address Line | 8230 BOONE BLVD STE 170
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City | VIENNA
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State | VA
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Zip | 22182-2621
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Country | US
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Telephone | 571-310-2502
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Fax |
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Provider Business Mailing Address
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Address Line | 2315 N FLORIDA ST
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City | ARLINGTON
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State | VA
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Zip | 22207-1729
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | HUBERT PHAM
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Credential |
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Telephone | 571-748-5432
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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