Organization
LIFELONG GOOD HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LUCIA ISAC MITCHELL RD (REGISTERED DIETITIAN)
(703) 389-6612
Entity
Organization
Contact information
Practice address
5721 RHODE ISLAND DR, WOODBRIDGE, VA 22193
(703) 389-6612
Mailing address
5721 RHODE ISLAND DR, WOODBRIDGE, VA 22193
(703) 389-6612
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
D1100000386
DC
Other
Enumeration date
07/18/2014
Last updated
07/18/2014
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