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General NPI Number Information
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NPI Number | 1205036597
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Entity Type | Organization
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Legal Business Name | RAPHA SPINE & NEURO CENTER-ANNANDALE, INC.
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Dates
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Enumeration Date | 07/24/2007
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Last Update Date | 07/24/2007
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Provider Practice Location Address
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Address Line | 46161 WESTLAKE DR SUITE 330
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City | POTOMAC FALLS
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State | VA
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Zip | 20165-5871
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Country | US
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Telephone | 703-444-4030
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Fax | 703-444-4142
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Provider Business Mailing Address
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Address Line | 46161 WESTLAKE DR SUITE 330
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City | POTOMAC FALLS
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State | VA
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Zip | 20165-5871
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Country | US
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Telephone | 703-444-4030
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Fax | 703-444-4142
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. DANIEL J. LEE
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Credential | DC
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Telephone | 703-444-4030
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 0104001364
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 0104001364
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License Number State | VA
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