Organization
MEDI-SSAGE CLINIC OF NORTHERN VIRGINIA
Active
Organization
MEDI-SSAGE CLINIC OF NORTHERN VIRGINIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIRIAM LEE WHITE LMT, MMP (OWNER)
(540) 347-3369
Entity
Organization
Contact information
Practice address
20 S 2ND ST, WARRENTON, VA 20186-3338
(540) 347-3369
Mailing address
20 S 2ND ST, WARRENTON, VA 20186-3338
(540) 347-3369
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
261QR0400X
Rehabilitation Clinic/Center
—
—
Other
Enumeration date
07/02/2012
Last updated
07/02/2012
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