Bull Run Foot And Ankle Clinic Gainesville Foot And Ankle Clinic
LBN: Tackle Management Corporation
Bull Run Foot And Ankle Clinic Gainesville Foot And Ankle Clinic is an health care organization with primary practice located at 8637 Mathis Ave , Manassas VA 20110-5270. The organization recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, which is considered as the primary health care specialty.
Tackle Management Corporation can be contacted via phone (703) 368-1800, or through Coates, Theresa Lynn via phone (703) 368-1800.
Contact Information
Primary practice address
8637 Mathis Ave
Manassas VA 20110-5270
Phone: (703) 368-1800
Fax: (703) 392-4820
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery | 213ES0103X | 0103000741 | Virginia |
Profile Details
| NPI number | 1831212067 |
|---|---|
| LBN Legal business name | Tackle Management Corporation |
| DBA Doing business as | Bull Run Foot And Ankle Clinic Gainesville Foot And Ankle Clinic |
| Authorized official | Coates, Theresa Lynn |
| Entity | Organization |
| Organization subpart 1 | Yes |
| Enumeration date | Apr 10th, 2007 |
| Last updated | Jul 31st, 2008 - about 16 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1831212067 | NPPES |
| Other | C10314 | MEDICARE PTAN |
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