Funk, Darryl Glen

Funk, Darryl Glen is an sole proprietor health care provider with primary practice located at 521 N Quincy St , Arlington VA 22203-2136. He recently has only one registered license in Residential Treatment Facilities / Substance Abuse Rehabilitation Facility, which is considered as his primary health care specialty. Funk, Darryl Glen can be contacted via phone (703) 841-0703.

Contact Information

Primary practice address
521 N Quincy St Arlington VA 22203-2136
Phone: (703) 841-0703
Fax: (703) 841-2316
Website:
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Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Substance Abuse Rehabilitation Facility 324500000X 0718000027 Virginia
Residential Treatment Facilities / Substance Abuse Rehabilitation Facility 324500000X Virginia

Profile Details

NPI number 1568612679
LBN Legal business name Funk, Darryl Glen
Credentials LSATP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 25th, 2008
Last updated Sep 25th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568612679 NPPES
Virginia MEDICAID 1558415968

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