Larry Mack-Wilson, P.A

NPI 1235413667 · on the registry since 2011

Practice

Address: 1850 Town Center Pkwy
Reston, VA 20190
Phone: (703) 689-9039
Fax: (703) 689-9109
Organisation at this address: Orthovirginia, Inc
Orthovirginia, Inc
Sohan R. Varma, Md
Orthovirginia, Inc
Orthovirginia, Inc.
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 229

Registry record

Primary taxonomy: 363AM0700X
363AM0700X
Licence states on file: VA
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2011-10-04

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Virginia