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Individual

JUAN POLANCO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
6051 BELSPRING RD, FAIRLAWN, VA 24141-8567
(540) 509-5443
(855) 889-9037
Mailing address
6051 BELSPRING RD, FAIRLAWN, VA 24141-8567
(540) 509-5443
(855) 889-9037

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
0701005818
VA
363AM0700X
Medical Physician Assistant
Primary
0110008672
VA

Other

Enumeration date
05/21/2014
Last updated
05/11/2026
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