| NPI | 1447992961 |
|---|---|
| Doing Business As | AVESTA KETAMINE AND WELLNESS |
| Entity Type | Organization |
| Authorized Contact | LADAN ESHKEVARI Owner 703-201-7767 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2022-04-13 |
| Last Update Date | 2022-04-13 |