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Organization
MEDICAL MANAGEMENT OF VA
Active
Organization
MEDICAL MANAGEMENT OF VA
Active
Other names
Natural Horizons Wellness Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PETER EWENS (PRESIDENT/ CEO)
(703) 246-9355
Entity
Organization
Contact information
Practice address
11230 WAPLES MILL RD, SUITE 125, FAIRFAX, VA 22030-6087
(703) 246-9355
Mailing address
11230 WAPLES MILL RD, SUITE 125, FAIRFAX, VA 22030
(703) 246-9355
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
NULL
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
12/09/2013
Last updated
12/09/2013
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