Individual
MARK EUGENE BODZISLAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.AC.
Contact information
Practice address
2111 EISENHOWER AVE STE 402, ALEXANDRIA, VA 22314-4679
(703) 717-9088
(703) 717-9158
Mailing address
13143 PUTNAM CIR, WOODBRIDGE, VA 22191-1026
(727) 692-3880
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
0121000889
VA
Other
Enumeration date
08/02/2018
Last updated
08/02/2018
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