Organization
THE POTOMAC SCHOOL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TERRENCE CUMMINGS L.A.T.C. (HEAD ATHLETIC TRAINER)
(703) 489-7632
Entity
Organization
Contact information
Practice address
1301 POTOMAC SCHOOL RD, MC LEAN, VA 22101-2350
(703) 489-7632
Mailing address
1301 POTOMAC SCHOOL RD, MC LEAN, VA 22101-2350
(703) 489-7632
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0126000115
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0126000115
2255A2300X
VA
Enumeration date
04/22/2015
Last updated
04/22/2015
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