| Organization Name: | MEDI-SSAGE CLINIC OF NORTHERN VIRGINIA |
| NPI Number: | 1013271360 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MIRIAM LEE WHITE (OWNER) |
| Mailing Address: | 20 S 2nd St Warrenton |
| State: | VA US |
| Postal Code: | 201863338 |
| Phone Number: | 5403473369 |
| Fax Number: | |
| NPI Enumeration Date: | 07/02/2012 |
| NPI Last Update Date: | 07/02/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rehabilitation |
| Taxonomy Definition: | |