Organization
CAPITOL HEALTH GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BONNIE SULLIVAN (PRACTICE ADMINISTRATOR AND OWNER)
(215) 680-7030
Entity
Organization
Contact information
Practice address
1900 CAMPUS COMMONS DR STE 100, RESTON, VA 20191-1535
(703) 766-5771
Mailing address
1900 CAMPUS COMMONS DR STE 100, RESTON, VA 20191-1535
(703) 766-5771
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
08/20/2021
Last updated
09/14/2021
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