Provider Demographics
NPI:1477906055
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:TABATHA
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
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 1:8001 BRADDOCK RD
Practice Address - Street 2:SUITE 100
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22151-2115
Practice Address - Country:US
Practice Address - Phone:800-521-8065
Practice Address - Fax:703-842-8416
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INDUSTRIAL HEALTH, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-07-19
Last Update Date:2016-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305210019225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty