| NPI | 1003426297 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACK EDWARD BAL Owner 703-967-9981 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| 235Z00000X Speech-Language Pathologist, | |
| 261QP2000X Clinic/Center, Physical Therapy | |
| Enumeration Date | 2020-08-03 |
| Last Update Date | 2022-02-26 |