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General NPI Number Information
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NPI Number | 1538826821
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Entity Type | Organization
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Legal Business Name | ESTHERS HOME CLINIC LLC
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Dates
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Enumeration Date | 11/21/2021
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Last Update Date | 08/17/2022
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Provider Practice Location Address
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Address Line | 6829 GRINNEL LN
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City | HAYMARKET
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State | VA
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Zip | 20169-2731
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Country | US
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Telephone | 571-247-7636
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Fax |
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Provider Business Mailing Address
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Address Line | 6829 GRINNEL LN
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City | HAYMARKET
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State | VA
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Zip | 20169-2731
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Country | US
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Telephone | 571-247-7636
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ESTHER H HONG
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Credential | NP
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Telephone | 571-247-7636
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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