Provider Demographics
NPI:1891396610
Name:MID-ATLANTIC INTEGRATIVE NEUROMUSCULOSKELETAL REHAB MEDICIN
Entity Type:Organization
Organization Name:MID-ATLANTIC INTEGRATIVE NEUROMUSCULOSKELETAL REHAB MEDICIN
Other - Org Name:ATLANTIC WELLNESS & INTEGRATIVE HEALTH SPECIALTY CLINIC LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/MEMBER/EMPLOYEE
Authorized Official - Prefix:
Authorized Official - First Name:ROSEMARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:FILART
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-888-8516
Mailing Address - Street 1:1390 CHAIN BRIDGE RD STE 10054
Mailing Address - Street 2:
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-3904
Mailing Address - Country:US
Mailing Address - Phone:571-488-9700
Mailing Address - Fax:
Practice Address - Street 1:20300 SENECA MEADOWS PKWY STE 215
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20876-7021
Practice Address - Country:US
Practice Address - Phone:571-488-9700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-06
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center