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Organization

FEDSERVE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DANIEL ODUKOYA (MANAGING DIRECTOR)
(301) 841-5077
Entity
Organization

Contact information

Practice address
8003 FRANKLIN FARMS DR RM 102, RICHMOND, VA 23229-5107
(301) 841-5077
Mailing address
8003 FRANKLIN FARMS DR RM 102, RICHMOND, VA 23229-5107

Taxonomy

Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
261QM0850X
Adult Mental Health Clinic/Center
261QP2000X
Physical Therapy Clinic/Center
Primary

Other

Enumeration date
01/06/2023
Last updated
09/04/2024
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