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General NPI Number Information
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NPI Number | 1700153418
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Entity Type | Organization
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Legal Business Name | DYNOX
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Dates
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Enumeration Date | 11/23/2011
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Last Update Date | 08/17/2018
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Provider Practice Location Address
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Address Line | 11815 FOUNTAIN WAY STE 360
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City | NEWPORT NEWS
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State | VA
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Zip | 23606
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Country | US
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Telephone | 757-696-8670
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2063
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City | NEWPORT NEWS
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State | VA
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Zip | 23609-0063
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Country | US
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Telephone | 757-696-8670
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | TONY WILLIAMS
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Credential |
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Telephone | 757-696-8670
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | VA
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