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General NPI Number Information
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NPI Number | 1790100477
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Entity Type | Organization
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Legal Business Name | LANSDOWNE WEIGHTLOSS & WELLNESS LLC
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Dates
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Enumeration Date | 03/04/2014
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Last Update Date | 07/29/2015
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Provider Practice Location Address
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Address Line | 19500 SANDRIDGE WAY # 170
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City | LEESBURG
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State | VA
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Zip | 20176-3688
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Country | US
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Telephone | 703-554-1300
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Fax |
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Provider Business Mailing Address
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Address Line | 19500 SANDRIDGE WAY # 170
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City | LEESBURG
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State | VA
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Zip | 20176-3688
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Country | US
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Telephone | 703-554-1300
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. HEATHER PARRESOL
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Credential |
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Telephone | 703-554-1300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QB0002X
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Taxonomy Name | Obesity Medicine (Family Medicine) Physician
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License Number | 0101-22-5778
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License Number State | VA
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