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General NPI Number Information
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NPI Number | 1972187540
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Entity Type | Organization
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Legal Business Name | MILLENNIUM TOTAL HEALTH AND FITNESS
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Dates
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Enumeration Date | 05/10/2021
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Last Update Date | 05/10/2021
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Provider Practice Location Address
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Address Line | 8101 HINSON FARM RD
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City | ALEXANDRIA
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State | VA
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Zip | 22306-3403
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Country | US
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Telephone | 571-371-8325
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Fax |
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Provider Business Mailing Address
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Address Line | 8101 HINSON FARM RD STE 318
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City | ALEXANDRIA
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State | VA
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Zip | 22306-3408
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Country | US
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Telephone | 571-371-8325
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | DR. ROTIMI A ILUYOMADE
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Credential | MD
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Telephone | 571-371-8325
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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