Clinica of Virginia LLC

NPI #1174841324 in Fairfax, Virginia

Provider Information

NPI Number: 1174841324
Entity Type: Organization
Organization Name: Clinica of Virginia LLC
Primary Specialty: Internal Medicine
Enumeration Date: May 12, 2010
Last Updated: May 12, 2010

Practice Location

Address: 10560 MAIN ST
Address 2: #215
City: Fairfax
State: Virginia
ZIP Code: 22030-7182
Phone: (571) 432-0700

Authorized Official

Name: MR. WOODROW ALLEN BOYER, EGM
Title: EXECUTIVE GENERAL MANAGER
Phone: (863) 614-0371

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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