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Boundless Nutrition LLC — NPI 1033828694, Fairfax, VA | NPI Central

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NPI 1033828694

OrganizationActive

Boundless Nutrition LLC

NPI 1033828694 · Clinic/Center · Fairfax, VA

Provider details

NPI number: 1033828694
Entity type: Organization
Primary specialty: Clinic/CenterAmbulatory Health Care Facilities
Organization subpart: No
Authorized official: Miriam Eackloff, Owner(703) 705-2720

Specialties & taxonomies

Clinic/CenterPrimary261Q00000X
Ambulatory Health Care Facilities

Practice location

13112 Moss Ranch Ln

Fairfax, VA 22033-3524

Phone: (703) 705-2720

Approximate (ZIP-level) locationGet directions

More VA providers

Mailing address

13112 Moss Ranch Ln

Fairfax, VA 22033-3524

Registry dates

Enumerated: 2022-11-22
Last updated: 2022-11-22
Certified: 2022-11-22

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.