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Organization
INTEGRATIVE HYPERBARIC & WOUND CARE LLC
Active
Organization
INTEGRATIVE HYPERBARIC & WOUND CARE LLC
Active
Parent organization
VIRGINIA FUNCTIONAL MEDICINE INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
VIRGINIA FUNCTIONAL MEDICINE INC
Authorized official
CALISTA PETRIE (CASE MANAGER)
(703) 938-1421
Entity
Organization
Contact information
Practice address
410 PINE ST SE, SUITE 330, VIENNA, VA 22180-4861
(703) 938-1421
(703) 938-1424
Mailing address
410 PINE ST SE, SUITE 330, VIENNA, VA 22180-4861
(703) 938-1421
(703) 938-1424
Taxonomy
Speciality
Code
Description
License number
State
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
Primary
—
NULL
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
Primary
—
—
208600000X
Surgery Physician
—
NULL
208600000X
Surgery Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
—
NULL
208VP0014X
Interventional Pain Medicine Physician
—
—
261QA1903X
Ambulatory Surgical Clinic/Center
—
NULL
Other
Enumeration date
04/10/2015
Last updated
04/16/2024
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