Organization
PROSPERITY PA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL GLYNN (COUNSEL)
(703) 544-8971
Entity
Organization
Contact information
Practice address
2755 HARTLAND RD STE 204, FALLS CHURCH, VA 22043-3544
(703) 544-8971
Mailing address
2755 HARTLAND RD STE 204, FALLS CHURCH, VA 22043-3544
(703) 544-8971
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
—
—
Other
Enumeration date
05/11/2023
Last updated
05/11/2023
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