Organization
OASIS OF LIFE, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN STEPHEN GALVIN (VICE PRESIDENT)
(571) 274-6460
Entity
Organization
Contact information
Practice address
6920 BRADDOCK ROAD B260, ANNANDALE, VA 22003
(571) 274-6460
Mailing address
6920 BRADDOCK ROAD B260, ANNANDALE, VA 22003
(571) 274-6460
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
05/21/2014
Last updated
11/17/2014
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