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General NPI Number Information
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NPI Number | 1285965194
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Entity Type | Organization
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Legal Business Name | ADVANCED PHYSICAL MEDICINE & REHABILITATION OF VIRGINIA
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Dates
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Enumeration Date | 01/18/2010
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Last Update Date | 01/18/2010
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Provider Practice Location Address
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Address Line | 5130 WILSON BLVD
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City | ARLINGTON
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State | VA
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Zip | 22205-1121
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Country | US
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Telephone | 202-596-1490
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 31223
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City | EDMOND
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State | OK
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Zip | 73003-0021
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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 | ADMIN DIRECTOR
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Name | ALI HEIDARPOUR
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Credential |
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Telephone | 202-487-5030
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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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