Organization
BECKWITH INTEGRATIVE MEDICINE, PLLC
Active
Other names
Amygdala
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROSHELLE BECKWITH (OWNER)
(703) 687-4158
Entity
Organization
Contact information
Practice address
952 EDWARDS FERRY RD NE, LEESBURG, VA 20176-3324
(703) 687-4158
(703) 687-4159
Mailing address
952 EDWARDS FERRY RD NE, LEESBURG, VA 20176-3324
(703) 687-4158
(703) 687-4159
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1235162280
1235162280
VA
05
—
1235162280
—
VA
01
—
1326514316
1326514316
VA
05
—
1326514316
—
VA
Enumeration date
07/15/2019
Last updated
07/15/2019
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