Organization
ADVANCED SPINE AND PAIN PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS J RALEY MD (OWNER)
(703) 522-2727
Entity
Organization
Contact information
Practice address
11230 WAPLES MILL RD STE 114C, FAIRFAX, VA 22030-5026
(703) 522-2727
Mailing address
450 GARRISONVILLE RD # 210, STAFFORD, VA 22554-1615
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Enumeration date
04/09/2020
Last updated
04/09/2020
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