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General NPI Number Information
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NPI Number | 1922516343
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Entity Type | Organization
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Legal Business Name | INOVA-SPH INSTITUTE OF TRADITIONAL CHINESE MEDICINE LLC
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Dates
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Enumeration Date | 01/19/2018
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Last Update Date | 01/19/2018
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Provider Practice Location Address
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Address Line | 3833 NORTH FAIRFAX DRIVE
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City | ARLINGTON
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State | VA
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Zip | 22203
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Country | US
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Telephone | 571-665-6700
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Fax |
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Provider Business Mailing Address
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Address Line | 8110 GATEHOUSE RD STE 200E
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City | FALLS CHURCH
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State | VA
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Zip | 22042-1210
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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 | EXECUTIVE VICE PRESIDENT
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Name | JAMES SANTRY
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Credential |
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Telephone | 703-289-2024
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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