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NPI 1558615054

NPI 1558615054 : FRANCINE SALAS M. S., A.T.C., L.A.T : TYSONS CORNER, VA

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General NPI Number Information
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    NPI Number           |    1558615054
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    Entity Type          |    Individual 
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    Provider Name        |    FRANCINE SALAS M. S., A.T.C., L.A.T
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    11/05/2012
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    Last Update Date     |    11/05/2012
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Provider Practice Location Address
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    Address Line         |    8130 BOONE BLVD STE 200 
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    City                 |    TYSONS CORNER
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    State                |    VA
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    Zip                  |    22182-2666
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    Country              |    US
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    Telephone            |    703-760-8110
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2171 ASTORIA CIR APT 116 
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    City                 |    HERNDON
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    State                |    VA
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    Zip                  |    20170-4052
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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    |    
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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       |    
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    License Number State |    
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