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General NPI Number Information
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NPI Number | 1205675527
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Entity Type | Organization
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Legal Business Name | ATLAS & AXIS, LLC
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Dates
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Enumeration Date | 05/24/2024
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Last Update Date | 05/24/2024
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Provider Practice Location Address
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Address Line | 3921 BLENHEIM BLVD STE 71C
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City | FAIRFAX
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State | VA
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Zip | 22030-2429
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Country | US
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Telephone | 703-750-8918
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Fax |
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Provider Business Mailing Address
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Address Line | 4766 TATUM MILL WAY
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City | CHANTILLY
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State | VA
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Zip | 20151-2148
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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 | OWNER
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Name | DR. EDDIE KIM
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Credential | DC
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Telephone | 703-975-0842
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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