# INTEGRATIVE HYPERBARIC & WOUND CARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** VIRGINIA FUNCTIONAL MEDICINE INC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1922494459
- **Legal business name:** VIRGINIA FUNCTIONAL MEDICINE INC
- **Authorized official:** CALISTA PETRIE (CASE MANAGER)
- **Authorized official phone:** (703) 938-1421

## Contact information

- **Practice address:** 410 PINE ST SE, SUITE 330, VIENNA, VA 22180-4861
- **Practice address phone:** (703) 938-1421
- **Practice address fax:** (703) 938-1424
- **Mailing address:** 410 PINE ST SE, SUITE 330, VIENNA, VA 22180-4861
- **Mailing address phone:** (703) 938-1421
- **Mailing address fax:** (703) 938-1424

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2083P0011X | Undersea and Hyperbaric Medicine (Preventive Medicine) Physician | — | NULL | Yes |
| 2083P0011X | Undersea and Hyperbaric Medicine (Preventive Medicine) Physician | — | — | Yes |
| 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