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General NPI Number Information
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NPI Number | 1356793541
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Entity Type | Individual
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Provider Name | ANDREA PAIGHT
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Gender | Female
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Dates
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Enumeration Date | 07/12/2016
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Last Update Date | 07/12/2016
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Provider Practice Location Address
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Address Line | 200 S CARLIN SPRINGS RD
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City | ARLINGTON
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State | VA
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Zip | 22204-1014
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Country | US
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Telephone | 703-228-6800
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Fax | 703-998-3069
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Provider Business Mailing Address
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Address Line | 1813 S POLLARD ST
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City | ARLINGTON
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State | VA
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Zip | 22204-5145
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Country | US
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Telephone | 571-882-4151
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 0126001118
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License Number State | VA
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