Individual
MICHAEL CENTRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1760 OLD MEADOW ROAD, SUITE 205, MCLEAN, VA 22102-4330
(703) 810-5214
Mailing address
1115 BOULDERS PARKWAY, SUITE 200, N CHESTERFIELD, VA 23225-4067
(804) 560-5595
(804) 968-1803
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
010001734
DC
225X00000X
Occupational Therapist
Primary
0119008514
VA
Other
Enumeration date
04/13/2020
Last updated
08/19/2022
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