NPI 1083157499

Boden Fitness System LLC

Organisation Preferred Provider Organization Winchester, VA

Practice location

Address: 125 Prosperity Dr Suite 500b, Winchester, VA 22602-5385
Phone: (540) 508-0779
Fax: (540) 508-0841

Authorised official

Name: Jordan Le Tran
Title: Medical Director
Phone: (540) 508-0779

Registered specialties

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X Licence 0101256096 (VA)

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Registry record

NPI: 1083157499
Entity type: Organization
NPI issued: 2 Dec 2016
Record last updated: 2 Dec 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.