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General NPI Number Information
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NPI Number | 1912045105
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Entity Type | Organization
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Legal Business Name | UNITED MEDICAL MANAGEMENT, INC.
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Dates
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Enumeration Date | 02/01/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 8300 GREENSBORO DR SUITE 800
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City | MC LEAN
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State | VA
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Zip | 22102-3605
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Country | US
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Telephone | 310-643-1640
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Fax |
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Provider Business Mailing Address
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Address Line | 2221 ROSECRANS AVE SUITE 111
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City | EL SEGUNDO
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State | CA
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Zip | 90245-4931
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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 | PRESIDENT
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Name | GREGG M KELBAUGH
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Credential |
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Telephone | 310-643-1860
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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