Privia Medical Group, LLC
NPI #1225689698 in Springfield, Virginia
Provider Information
- NPI Number
- 1225689698
- Entity Type
- Organization
- Organization Name
- Privia Medical Group, LLC
- Primary Specialty
- Podiatrist
- Enumeration Date
- Sep 26, 2019
- Last Updated
- Mar 11, 2020
Practice Location
- Address
- 6128 BRANDON AVE STE 201
- City
- Springfield
- State
- Virginia
- ZIP Code
- 22150-2693
- Phone
- (571) 366-8850
Authorized Official
- Name
- COURTNEY AINSWORTH IVESS
- Title
- ASSOCIATE DIRECTOR, CREDENTIALING
- Phone
- (571) 366-8831
Specialties & Taxonomy Codes
| Specialty |
|---|
| Podiatrist |
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