# MISSION FUNCTIONAL MEDICINE, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225514136
- **Authorized official:** MR. SHAWN C LAWSON (OFFICE MANAGER)
- **Authorized official phone:** (540) 247-8476

## Contact information

- **Practice address:** 230 COSTELLO DR STE 210, WINCHESTER, VA 22602-4310
- **Practice address phone:** (540) 247-8476
- **Practice address fax:** (540) 869-3524
- **Mailing address:** 103 CHANCELLORSVILLE DR, STEPHENS CITY, VA 22655-4515
- **Mailing address phone:** (540) 247-8476

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 0102202773 | VA | Yes |

## Other

- **Enumeration date:** 07/13/2018
- **Last updated:** 07/13/2018