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ALEXANDRIA, VA
NPI1609249697
Entity TypeOrganization
Authorized ContactBYESHEBA ENTZMINGER-BULLOCK
Owner/Administrator
571-403-9871
Organization Subpart ?No
Primary Taxonomy251S00000X 
Enumeration Date2015-11-12
Last Update Date2015-11-12
Business Address
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6381 LITTLE RIVER TPKE
ALEXANDRIA, VA 22312-5002
Phone number: 571-403-9871
Mailing Address
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6381 LITTLE RIVER TPKE
ALEXANDRIA, VA 22312-5002
Phone number: