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General NPI Number Information
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NPI Number | 1871249029
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Entity Type | Organization
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Legal Business Name | JP GRP LLC
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Dates
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Enumeration Date | 02/25/2022
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Last Update Date | 02/25/2022
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Provider Practice Location Address
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Address Line | 7412 MARC DR
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City | FALLS CHURCH
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State | VA
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Zip | 22042-3612
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Country | US
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Telephone | 703-853-7147
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Fax |
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Provider Business Mailing Address
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Address Line | 7412 MARC DR
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City | FALLS CHURCH
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State | VA
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Zip | 22042-3612
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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 | DIRECTOR
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Name | MR. JATINDERPAL SAYAL
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Credential |
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Telephone | 703-853-7147
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 202K00000X
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Taxonomy Name | Phlebology Physician
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License Number |
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License Number State |
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