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General NPI Number Information
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NPI Number | 1780359471
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Entity Type | Organization
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Legal Business Name | NEW LIFE HEALTH & WELLNESS CARE, PLLC
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Dates
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Enumeration Date | 08/13/2021
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Last Update Date | 08/13/2021
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Provider Practice Location Address
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Address Line | 6515 WAYSIDE PL
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City | ALEXANDRIA
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State | VA
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Zip | 22310-2865
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Country | US
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Telephone | 571-312-4693
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Fax |
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Provider Business Mailing Address
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Address Line | 6515 WAYSIDE PL
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City | ALEXANDRIA
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State | VA
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Zip | 22310-2865
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Country | US
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Telephone | 571-312-4693
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Fax |
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Authorized Official
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Title or Position | OB/GYN
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Name | MARC HESTER
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Credential | M.D.
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Telephone | 571-289-4935
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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