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General NPI Number Information
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NPI Number | 1205989621
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Entity Type | Organization
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Legal Business Name | ABC CHILDREN'S HEALTH CENTER
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Dates
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Enumeration Date | 01/19/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 91 TINKLING SPRING DR
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City | FISHERSVILLE
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State | VA
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Zip | 22939-2303
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Country | US
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Telephone | 540-886-8677
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Fax | 540-886-8678
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Provider Business Mailing Address
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Address Line | 91 TINKLING SPRING DR
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City | FISHERSVILLE
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State | VA
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Zip | 22939-2303
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Country | US
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Telephone | 540-886-8677
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Fax | 540-886-8678
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | JILL M BOOTH
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Credential |
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Telephone | 540-886-8677
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State | VA
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