Organization · Type 2 NPI

Tackle Management Corporation

Foot & Ankle Surgery Podiatrist · Manassas, VA

NPI number 1831212067 Active

Practice location

8637 Mathis Ave
Manassas, VA 20110-5270

Fax (703) 392-4820

Specialties and licenses

Taxonomy	Code	License
Foot & Ankle Surgery Podiatrist Primary	213ES0103X	0103000741 (VA)

Foot & Ankle Surgery Podiatrist: Definition to come...

4 other providers at this address

Listen Nutrition, LLCRegistered Dietitian Manassas, VA NPI 1093471187
Nancy Crespo-Richardson LLCProfessional Counselor Manassas, VA NPI 1700482569
Tackle Management CorporationFoot & Ankle Surgery Podiatrist Manassas, VA NPI 1033399688
Nancy Katherine Crespo-Richardson, LPCProfessional Counselor Manassas, VA NPI 1801440128

Other foot & ankle surgery podiatrist providers in Manassas

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NPI record

NPI: 1831212067
Entity type: Organization (Type 2)
Issued: Apr 10, 2007
Last updated: Jul 31, 2008
Status: Active
Subpart: Yes of Tackle Management Corporation

Other names

<unavail>
Bull Run Foot and Ankle Clinic Gainesville Foot and Ankle Clinic · doing business as

Authorized official

Mrs. Theresa Lynn Coates
Practice Administrator
(703) 368-1800

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1831212067

Tackle Management Corporation's National Provider Identifier is 1831212067, issued on Apr 10, 2007. The primary taxonomy on file is Foot & Ankle Surgery Podiatrist (213ES0103X), and the practice location is in Manassas, VA. The record was last updated on Jul 31, 2008.