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General NPI Number Information
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NPI Number | 1437210697
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Entity Type | Organization
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Legal Business Name | NEUROLOGY & ACUPUNCTURE CLINC PLC
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Dates
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Enumeration Date | 12/12/2006
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Last Update Date | 04/05/2018
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Provider Practice Location Address
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Address Line | 1520 BREEZEPORT WAY SUITE 600
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City | SUFFOLK
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State | VA
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Zip | 23435
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Country | US
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Telephone | 757-638-3316
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Fax | 757-295-0859
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Provider Business Mailing Address
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Address Line | 15154 CARROLLTON BLVD SUITE A
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City | CARROLLTON
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State | VA
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Zip | 23314-2316
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Country | US
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Telephone | 757-745-7555
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Fax | 757-745-7559
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | CATHERINE M NEHLS
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Credential |
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Telephone | 757-745-7555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 0101229252
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License Number State | VA
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