Organization
VIRGINIA INTEGRATIVE PRACTICE
Active
Other names
VIVA Center
Organization subpart
No
Provider details
NPI number
Authorized official
VAJRA JAI (EXECUTIVE DIRECTOR)
(888) 299-4570
Entity
Organization
Contact information
Practice address
8996 BURKE LAKE RD STE 303, BURKE, VA 22015-1607
(888) 299-4570
(888) 398-0897
Mailing address
8996 BURKE LAKE RD STE 303, BURKE, VA 22015-1607
(888) 299-4570
(888) 398-0897
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0101242686
VA
207V00000X
Obstetrics & Gynecology Physician
0101244564
VA
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
09/15/2017
Last updated
07/21/2022
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