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General NPI Number Information
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NPI Number | 1477906055
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Entity Type | Organization
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Legal Business Name | INDUSTRIAL HEALTH, LLC
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Dates
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Enumeration Date | 07/19/2016
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Last Update Date | 09/19/2016
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Provider Practice Location Address
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Address Line | 8001 BRADDOCK RD SUITE 100
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City | SPRINGFIELD
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State | VA
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Zip | 22151-2115
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Country | US
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Telephone | 800-521-8065
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Fax | 703-842-8416
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Provider Business Mailing Address
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Address Line | PO BOX 316
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City | OAKTON
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State | VA
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Zip | 22124-0316
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Country | US
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Telephone | 800-521-8065
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Fax | 703-842-8416
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | TABATHA JONES
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Credential |
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Telephone | 800-521-8065
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2305210019
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License Number State | VA
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