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General NPI Number Information
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NPI Number | 1801364781
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Entity Type | Organization
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Legal Business Name | KYNETIC MEDICAL GROUP INC
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Dates
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Enumeration Date | 11/08/2018
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Last Update Date | 05/06/2021
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Provider Practice Location Address
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Address Line | 5549 MAPLEDALE PLZ
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City | WOODBRIDGE
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State | VA
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Zip | 22193-4527
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Country | US
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Telephone | 703-763-3877
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Fax | 703-763-3945
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Provider Business Mailing Address
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Address Line | 5549 MAPLEDALE PLZ
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City | WOODBRIDGE
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State | VA
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Zip | 22193-4527
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Country | US
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Telephone | 703-763-3877
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Fax | 703-763-3945
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Authorized Official
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Title or Position | CEO
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Name | JORDANA LEE ARPA
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Credential |
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Telephone | 703-763-3877
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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