institution
Tackle Management Corporation
Foot & Ankle Surgery Podiatrist in Manassas, Virginia
NPI 1831212067

Tackle Management Corporation is a Foot & Ankle Surgery Podiatrist based in Manassas, VA and is specialized in Foot & Ankle Surgery. Tackle Management Corporation practices in Manassas, VA. The NPI Number for Tackle Management Corporation is 1831212067 and holds a License No. 0103000741 (Virginia).

The current practice location address for Tackle Management Corporation is 8637 Mathis Ave, Manassas, VA and can be reached out via phone at 703-368-1800 and via fax at 703-392-4820.

Location: 8637 Mathis Ave, Manassas, VA, 20110-5270
institution
Provider Profile Details
NPI Number
1831212067
Provider Name
Tackle Management Corporation
Credential
Provider Entity Type
Organization
Address
8637 Mathis Ave, Manassas, VA, 20110-5270
Phone Number
703-368-1800
Fax Number
703-392-4820
Provider Enumeration Date
04/10/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
C10314 01 MEDICARE PTAN
institution
Provider Business Practice Location Address Details
Address
8637 Mathis Ave
City
State
Zip
20110-5270
Phone Number
703-368-1800
Fax Number
703-392-4820
person
Provider Business Mailing Address Details
Address
8637 Mathis Ave
City
State
Zip
20110-5270
Phone Number
703-368-1800
Fax Number
703-392-4820
person
Provider's Taxonomy Details 1
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Foot & Ankle Surgery
Taxonomy
License No.
0103000741 (Virginia)
Definition
Definition to come...
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