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General NPI Number Information
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NPI Number | 1427400159
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Entity Type | Organization
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Legal Business Name | EIGENLINE CORP.
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Dates
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Enumeration Date | 07/06/2016
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Last Update Date | 07/06/2016
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Provider Practice Location Address
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Address Line | 11526 SENECA WOODS CT
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City | GREAT FALLS
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State | VA
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Zip | 22066-1375
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Country | US
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Telephone | 512-710-6860
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1048
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City | GREAT FALLS
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State | VA
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Zip | 22066-9048
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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 | MANAGER
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Name | MR. ROBERT L RATCLIFFE III
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Credential |
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Telephone | 703-544-7081
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RS0012X
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Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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