| NPI | 1043441223 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TASHA LATRICE YOUNG Chief Physician Officer/Podiatrist 703-466-0455 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0131X (Licence: VA 0103300977) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: VA 0104556539) |
| Enumeration Date | 2009-08-05 |
| Last Update Date | 2011-09-14 |