Provider Demographics
NPI:1356852628
Name:INDUSTRIAL HEALTH, LLC
Entity Type:Organization
Organization Name:INDUSTRIAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BRANDI
Authorized Official - Middle Name:
Authorized Official - Last Name:LANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-521-8065
Mailing Address - Street 1:PO BOX 316
Mailing Address - Street 2:
Mailing Address - City:OAKTON
Mailing Address - State:VA
Mailing Address - Zip Code:22124-0316
Mailing Address - Country:US
Mailing Address - Phone:800-521-8065
Mailing Address - Fax:703-842-8416
Practice Address - Street 1:7794 MARLBORO PIKE
Practice Address - Street 2:
Practice Address - City:FORESTVILLE
Practice Address - State:MD
Practice Address - Zip Code:20747-4410
Practice Address - Country:US
Practice Address - Phone:800-521-8065
Practice Address - Fax:703-842-8416
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-13
Last Update Date:2017-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD22964208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty