Organization
DMV SPORTS MEDICINE INSTITUTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEIRON HOLMES (OWNER)
(793) 314-9891
Entity
Organization
Contact information
Practice address
13576 MINNIEVILLE RD, WOODBRIDGE, VA 22192-4203
(703) 314-9891
Mailing address
15597 HORSESHOE LN, WOODBRIDGE, VA 22191-4128
(703) 314-9891
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
2305205379
VA
Other
Enumeration date
04/08/2015
Last updated
04/08/2015
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