Provider Demographics
NPI:1790100477
Name:LANSDOWNE WEIGHTLOSS & WELLNESS LLC
Entity Type:Organization
Organization Name:LANSDOWNE WEIGHTLOSS & WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:PARRESOL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-554-1300
Mailing Address - Street 1:19500 SANDRIDGE WAY
Mailing Address - Street 2:# 170
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-3688
Mailing Address - Country:US
Mailing Address - Phone:703-554-1300
Mailing Address - Fax:
Practice Address - Street 1:19500 SANDRIDGE WAY
Practice Address - Street 2:# 170
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-3688
Practice Address - Country:US
Practice Address - Phone:703-554-1300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-04
Last Update Date:2015-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101-22-5778207QB0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QB0002XAllopathic & Osteopathic PhysiciansFamily MedicineObesity MedicineGroup - Multi-Specialty