Provider Demographics
NPI:1588909857
Name:GREATER WASHINGTON ASSOCIATES IN EXERCISE PHYSIOLOGY
Entity type:Organization
Organization Name:GREATER WASHINGTON ASSOCIATES IN EXERCISE PHYSIOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:VERNON
Authorized Official - Middle Name:
Authorized Official - Last Name:BOND
Authorized Official - Suffix:
Authorized Official - Credentials:RCEP, PHD
Authorized Official - Phone:202-806-7545
Mailing Address - Street 1:1231 GOOD HOPE RD SE STE 106B
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-6907
Mailing Address - Country:US
Mailing Address - Phone:202-271-8559
Mailing Address - Fax:202-486-7504
Practice Address - Street 1:1231 GOOD HOPE RD SE STE 106B
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-6907
Practice Address - Country:US
Practice Address - Phone:202-271-8559
Practice Address - Fax:202-486-7504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-28
Last Update Date:2014-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224Y00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersClinical Exercise PhysiologistGroup - Single Specialty
No133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty