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Organization

CHANTILLY SPECIALISTS, LTD.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ROBERTA MILLSAP (ADMIN ASSISTANT)
(703) 378-3854
Entity
Organization

Contact information

Practice address
14121 PARKE LONG CT, SUITE 112, CHANTILLY, VA 20151-1647
(703) 378-3854
(703) 378-4909
Mailing address
14121 PARKE LONG CT, SUITE 112, CHANTILLY, VA 20151-1647
(703) 378-3854
(703) 378-4909

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary

Other

Enumeration date
08/12/2006
Last updated
05/06/2008
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