Provider Demographics
NPI:1619606258
Name:ANDERSON CLINIC INC
Entity Type:Organization
Organization Name:ANDERSON CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:D
Authorized Official - Last Name:HORDGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-769-8423
Mailing Address - Street 1:2445 ARMY NAVY DR STE 15
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22206-2998
Mailing Address - Country:US
Mailing Address - Phone:703-892-6500
Mailing Address - Fax:
Practice Address - Street 1:10716 RICHMOND HWY STE 103
Practice Address - Street 2:
Practice Address - City:LORTON
Practice Address - State:VA
Practice Address - Zip Code:22079-2645
Practice Address - Country:US
Practice Address - Phone:703-892-6500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ANDERSON CLINIC LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-06-08
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy